Annual Report 2010

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Serving with Altruism

The Smile Stone 5000 With your Heart, Serve with the Blessings of Love, With your Eyes, Serve with the Vision of Brotherhood, With your Mind, Serve with Pure Thoughts, With your Words, Serve to Enlighten Others, And with your Actions, Serve to Uplift the Lives of Others...

Editorial Editor

Prof. Dr. N. Krishnamurthy Academic Director Associate Editor

Mr. P. T. Sundar Executive Secretary Concept & Co-ordination

Ms. C. Yalini Sheeba Manager - R&D Compilation

Mr. P. Sundarraj Senior Manager - R&D

Ms. M. P. Suganya Project Associate - R&D

Ms. R. Rajeswari Fundraising Executive - R&D

Ms. S. Malarvizhi Fundraising Executive - R&D

Ms. M. Muthuselvi Fundraising Executive - R&D Photography

Mr. B. Shanmugam Mr. N. Shankar

Board of Trustees Dr. N. Sethuraman Founder President / Chairman

Dr. (Mrs.) Rajam Sethuraman Executive Director

Dr. S. Gurushankar Vice Chairman

Ar. S. Ramesh Vice President

Mr. S. Parthasarathy Mr. S. Manavalan Dr. K. A. Srinivasan Mr. A. Shanmugasundaram Mr. P. Velusamy Mr. S. Regunathan Mr. P. K. Amarnath Chartered Accountant


From the Chairman's Desk It is not enough to stare up the steps - We must step up the stairs…. Vision, Charity and Ability to transform ideas into reality are some of the qualities that have distinguished Meenakshi Mission Hospital since inception. Over 20 years of our Mission to provide affordable worldclass health care to all, we are indeed nearing and achieving our vision of “No man is too poor to afford first grade medical treatment”. As we mature, we learn new things, acquire new skills and take up to new challenges. And yet, ideally, while we change in so many ways we remain true to our core values, so it is with our Hospital also. By enjoying 20 years of our founding, we celebrate the changes over the years, have kept this hospital one of the finest in India. At the same time, we are proud that this institution continues to honour the values on which we were founded: Service to the Community. Yes, once again, I am proud to present the Annual Report for 2009-2010 of our hospital.


At Meenakshi Mission Hospital, we work earnestly towards our vision of being a sanctuary of care for the individuals in need of medical help. We not only strive to fulfill the medical and nursing needs of our patients, but also adopt a patient-friendly approach in which we treat our patients and their families as our partners in holistic care. Our hospital makes a difference, as our staff and volunteers serve the community with dedication and commitment towards Medical Excellence with a Heart. Together we endeavour to be one of the most competitive hospitals in the industry of health with emphasis on quality patient care delivery systems, efficiency in operations, reliability for stakeholders and thrust on discovery & actively undertake Clinical Medical Research. Over 20 years after our birth, we know more, we do more and we look very different. But times have never altered our commitment to the community that brought us to life. We are pleased about the Smile Train team for bringing 5000 and more cleft lip/palate surgeries, an achievement to the mankind! As the human existence is challenged by incomprehensible diseases and ailments, we attempt to reach the core of scientific processes to unearth their remedy. We are indebted to Direct Relief International - USA for their continuous medical assistance & initiating Telemedicine services by changing the face in rural community for better health care at their doorsteps. We are an organization that combines charity with scientific, financial, managerial and operational skills & resources to

rejuvenate life. We take much privilege in appreciating the services of Vitamin Angels Alliance, USA for their blindness control program for the children. The noble assistance of Americares, India by way of distributing medicines and medical assistance helped us widen our horizon in our service. Gearing up for the future, we have the key success factors, necessary to withstand the winds of change. The encouragement provided to build a highly skilled, creative development team, which is reinforced by the state-of-the-art infrastructure, new buildings construction development, new medical speciality wings, innovative projects etc. We have acquired a land in Kotakudi Village at Melur Taluk in Madurai District which is 20 kms from our Hospital to construct another 350-bed hospital and a training institute for medical and paramedical courses. We are also in the process of initiating a Medical College and develop into an University. On behalf of the Board, my sincere gratitude & thanks to the hospital trustees, administrative staff, medical and paramedical staff, patients, donors, stakeholders, government departments, well wishers and many volunteers for their valuable and important efforts during this past year. Together we care and strive forward, hand in hand to meet the challenges ahead with a heart in achieving our vision!

Dr. N. Sethuraman Founder Chairman


From the Vice Chairman's Desk


Healthcare The Lifeline Of The Nation On the heels of global economic downturn, things have swung in favour of the healthcare industry. This has witnessed corporate giants like the Ambanis, Hindujas, Saharas, Emami, Apollo Tyres and the Panacca group bank on the health care business because of its insulation from economic fluctuations. A recent news article suggested that, by the end of 2025, hospitals in India will need as many as 1.75 million additional beds which will require a staggering $86 billion investment. Given this scenario, we intend to play a vital role in meeting the needs of this mammoth task. After successful endeavour of providing affordable healthcare to the people of Madurai over the last 20 years, Meenakshi Mission Hospital is venturing into new geographic territories. Our hospital is also keen to look into other opportunities in the healthcare sector as Domestic Medical Tourism. The Annual report for the year 2009-10 records our successful completion of two decades in the healthcare industry and our accomplishments in the increasing number of cardiology patients. We have installed a Fixed Cathlab to achieve over the past year. As promised last year, we have also inaugurated our new Canteen block to cater to our staff and visitors with a delightfully sumptuous menu. Also, the installation of the Linear Accelerator is in the final stages and the equipment will be ready to diagnose cancer patients. This year, we inaugurated the state's first Paediatric Oncology department at our hospital, which will treat the early stages of cancer in children.

As proof to our passion to embrace new technology, the year ahead will witness the commissioning of the new high-end MRI equipment. We'll also be improvising on our efforts to educate one and all about the need for Preventive healthcare. As Meenakshi Mission Hospital has always been known for its critical care, we intend to increase our infrastructure of the same, to accommodate more patients. Our emergency department and IRCU are also under expansion. All these years, Meenakshi Mission Hospital has been thinking locally and all our advertising efforts have been in its neighbourhood. But now we have started thinking globally to break through the boundaries. As always, Meenakshi Mission Hospital has been receiving accolades from various forums and respectable individuals. The visit of Dr. A.P.J. Abdul Kalam, former Indian President to felicitate our achievement of performing more than 5000 free cleft lip / palate surgeries holds evidence to this fact. We would also wish to record the completion of 160 free heart surgeries. Our charity work has also continued and increased over the years by providing free meals to more than 8 lakhs of poor patients. We would like to thank our donors whose continued support has kept our hopes alive to serve the poor and the needy. Finally, on behalf of the board of trustees, I dedicate the completion of 20 years to the medical fraternity, paramedical staff and other staff, for their commitment and selfless service to the growth of the hospital. I, urge you to continue to work with the same intensity so we may flourish beyond boundaries. Dr. S. Gurushankar Vice Chairman


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Accident and Emergency Medicine Anaesthesiology &Pain Clinic Andrology & Urology Cardiac Anaesthesiology Cardio Thoracic & Vascular Surgery Cardiology Dental & Maxillofacial Surgery Dermatology & Venereology Diabetology General Medicine Imaging Science and Interventional Radiology Intensive Respiratory Care Unit (IRCU) Laboratory Services Medical Oncology Nephrology Neurology Neuro Surgery Nuclear Medicine Obesity clinic Obstetrics & Gynaecology Ophthalmology Orthopaedics & Traumatology Otorhinolaryngology (ENT) Paediatric Oncology Paediatrics & Neonatology Pharmacy Physical Medicine & Rehabilitation Plastic Surgery / The Regional Smile Train Centre Psychiatry & Counselling Radiation Oncology Reproductive Medicine Surgery & Surgical Gastroenterology Surgical Oncology Telemedicine – “Meenakshi Telecare”

2 5 7 10 13 16 20 22 23 25 27 29 31 33 35 39 40 42 43 44 47 48 53 55 57 61 62 64 66 67 70 72 74 76

Academic Excellence Library Meenakshi Mission Hospital College Leader in Health Information

Developmental Excellence Promotional Initiatives- The Marketing Department Quality Service Department Resource & Development

Financials Performance Highlights

Contents

Medical Excellence

79 - 86 80 81 86

87 - 102 88 91 93

103 - 105 106


MEDICAL EXCELLENCE


World class care within everybody's reach

Accident and Emergency Medicine

"Emergency erupts unexpectedly but needs to be managed immediately " Accidents, natural disasters and poisoning are the genesis of emergency medicine. It is a medical speciality wherein physicians are trained to provide care to patients with acute emergencies or

injuries

requiring immediate medical attention. Emergency physician aims to diagnose emergent conditions and stabilize the patients for definitive care. To understand the strong emerging needs, the Medical council of India has recognized Emergency Medicine as one of the specialities. It is an unique discipline and independent speciality with an exclusive knowledge to respond to life threatening events requiring acute intensive response. The Accident & Emergency Medicine Department is on its sojourn from a mere referral point to an independent self sufficient department. 24 x 7 emergency care with six available beds encompassing initial evaluation, diagnosis, treatment, and disposition of any patient requiring expeditious medical or surgical care. Trauma, Cardiac, Medical, Surgical, Toxicology, Burns etc. are the spectrum of cases which arrive on a daily basis, each one of them seeking apt attention leading to successful recovery of the patients. The department has been performing with high success rate of resuscitation, treating poisoning and other acute cases approaching the hospital.

2


World class care within everybody's reach The department is well organized and has

any emergency during transportation of the

been making constant efforts in making a

patients to ensure perfect treatment. In an effort

difference between life and death. It is staffed

to extend the knowledge of emergency medicine

by well trained qualified emergency

among others, the Department of Accident &

physicians, supported by dedicated medical

Emergency Medicine, in association with Indian

officers, nursing staff and paramedical staff

Medical Association conducted an exclusive

working in perfect coordination to make visible

CME programme focused on Toxicology and

differences. They are trained in basic life support

Trauma. This was the first CME in Madurai

and advanced cardiac life support which can

conducted by our Accident & Emergency

handle all kinds of emergencies effectively. The

Department. A team of Emergency Physicians

department is equipped with life saving

from CMC Vellore, Apollo Hospital, Hyderabad

equipments like defibrillators, ventilators,

and consultants from our hospital were the

cardiac monitors etc, and many more hitech

speakers. There was an overwhelming response

equipments will be added soon. “Zero waiting

from all the doctors in and around Madurai. This

time, perfect diagnosis, intensive care” are the

was one of the most successful CME

keywords and follow the motto of “saving lives”.

programmes conducted at our hospital which

Every patient in the department receives

was attended by more than 230 doctors.

appropriate and timely care with zero waiting time. The crucial role of patient management in the first hour is strictly abided as it determines the

Regular activities 1. Classes on Basic Life S u p p o r t

(BLS),

chance of their survival & hence every patient is

Advanced Cardiac Life Support (ACLS) and

treated aggressively for complete recovery. The

initial approach to

success rate in reviving a patient from cardiac

staff.

trauma patients for

arrest is as high as 67%, which is much higher

2. Presentations by nursing and paramedical

than in the developed nations (44% - 54%). More

staff on every Mondays and Fridays on

than 10000 patients were seen in our

topics related to emergency medicine.

department. This consistency has been well maintained since 2008.

Besides regular emergency services, the department also provides pre-hospital care service with its 3 ambulances for serious cases. The pre hospital care aims in taking

3. Classes and training for nursing students and trainees abroad. 4. Lectures to interns and post graduate students. 5. Lectures on first aid in emergencies to Security personnel and NGOs.

emergency services to the patients, before

6. Lectures and mannikin workshops for the

bringing them to the emergency room and

IMA doctors in and around Madurai

provide appropriate care on the field during

District.

the “Golden hour” to prevent death. The staff is adequately trained in advanced airway management (intubation) to handle

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World class care within everybody's reach

No. of Patients

Our Performance

Year The number of cases seen in the Accident & Emergency Department has drastically increased and is expected to rise further in the following years.

Total no. of patients seen in A & E department during the year 2009-2010 is 11,102, of which 2,492 were Medico-Legal Cases. (MLC)

Total no. of cardiac arrests revived during the year 2009-10 is 45 out of 67 (67% success)

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World class care within everybody's reach

Anaesthesiology and Pain Clinic

Today, making the patient insensitive without pain and monitoring & maintaining vital organ to function during surgery remains the major professional activity of an anaesthesiologist. The Department of Anaesthesia and Critical Care strives to address challenges in three overlapping ways. First, whether it is in the operating room or in ICU (our department contains 11 anaesthesiologists), we vow that every patient we see, receives the benefits of highest-quality care. Second, our prominent research programs keep us integrally involved in the generation, application, and dissemination of the scientific evidence upon which clinical practice is based. Third, our faculty is educating the next generation of anaesthesia leaders, as well as other physicians who can benefit from the anaesthesiologist's broad based training.

Our Performance General Anaesthesia

: 7543

Spinal / Epidural

: 2850

Plexus Blocks

: 0615

Nerve Blocks

: 0104

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World class care within everybody's reach

Pain Clinic

Conferences / Workshop attended

Various modalities of pain relief are given to patients for immediate postoperative pain relief and neurolytic block for those who are suffering with long-term pain.

Acute Pain Relief

Dr. N. Maharajan, Senior Consultant F o u r t h I n t e r n a t i o n a l Pa e d i a t r i c Anaesthesia Conference - 2009, Chennai. Association

IV Narcotics Infusion

- 1766

Continuous Epidural

- 0641

Subcutaneous Narcotics - 0016

of

Obstetrics.

Anaesthesiologists (National AOACON) – Sep 2009, Chandigarh and presented p a p e r o n “O u t c o m e A n a l y s i s o f Pulmonary Hypertension in Parturient

Labour Analgesia

- 0019

Dr. J. Rajesh, Junior Consultant

Chronic Pain Relief Gasserian Ganglion Block - 13 Coeliac Plexus Block

Patients – Retrospective Analysis”.

- 07

Lumbar Sympathetic Block - 03 Posterior nerve root Block

- 14

Epidural Steroid

- 43

RSACPCON – Oct 2009, New Delhi. Presented paper on “Comparative study of I- GEL and PROSEAL LMA in Laparoscopic surgery”. SZISACON – Sep 2009, Hyderabad poster presentation on “Anaesthetic Management of a pregnant female for Spine Surgery under one lung Ventilation”.

Academic Activities Our department is having an opportunity of teaching and training postgraduates in DNB. Two post DA candidates and two primary candidates are recognized by NBE. Lecture programmes, clinical case presentations and journal club discussions are undertaken twice in a week. PGs are evaluated and guided properly on preoperative assessment and given enough step by step training to manage simple to high risk cases. PGs are taking part in symposia and panel discussions. Clinical case presentations are also undertaken on Sundays once in a month. PGs are encouraged to take active part in presenting papers at Clinical Society Meetings and in State and National conferences also.

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Dr. Sanjogita, PG Paper presentation on “Effect of various doses of Ephedrine in blunting Propofol induced hypotension” at SZISACON - Sept 2009 at Hyderabad. Dr. V. K. Nair 2nd Memorial Oration – Oct 2009 was successfully conducted in our Hospital. Prof. D.M. Ambareesha, Kasturba Medical College, Mangalore delivered the oration on “Nerve Blocks in Palliative Care Current and Future Prospective”. About 120 delegates attended.


World class care within everybody's reach

20 years of leading from the front & showing the path

Andrology and Urology

In the past two decades, much of what has been envisaged was executed. There are constant changes in patterns of practice and disease all over the years. A decade back, we were treating stones in the young patients on their productive lives but today the stone profile has shifted ahead into 60’s and 70’s. These are the primary calculi and not calculi due to prostatic obstruction. Diabetes is also being diagnosed almost at any age but especially in the elderly into the eighties for the first time. It is terrifying to see diabetes produce fulminant infections in both kidneys (emphysematous pyelonephritis) or sometimes one followed by another even when the diabetes has been controlled quite reasonably. Such infections produce CKD with renal failure, if not mortality. There are many patients these days with unilateral obstructions with raised serum creatinine due to prolonged medical therapy and infection inspite of advancement in Urology. There is also a tremendous increase in the number of subjects either dysfunctional voiding, neurogenic bladder or urogynaecological problems especially nocturia. Paediatric Urology remains static with posterior urethral valves, the primary obstructive uropathy in early childhood. VUR is also seen as a common cause of urinary infections. Injection of deflux intra vesically to create a valvular ureteral orifice eliminates the reflux and need for prolonged chemoprophylaxis. Wilms' tumour seems to be in the decline.

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World class care within everybody's reach Prostate cancers, inspite of wide spread

shock wave lithotripsy as a modality of stone

application of PSA are picked up late, often

treatment. This is especially because of the

with metastases precluding radical treatment

flexible ureteroscopy with LASER which has

for cure. More renal tumours are picked up

enabled the management of intra-renal calculi

as incidentalomas and are fit for partial

especially in the lower calyx and also the fact that

nephrectomy (Nephron Sparing Surgery).

ESWL needs multiple sessions with high residual

Laparoscopic techniques have supplanted

stone rates (Low clearance).

conventional open surgery in the management of Adrenal tumours, Renal tumours, Pyeloplasty, Ureteric

Reimplantations,

Donor

Nephrectomies, Orchidopexy, VVF repair and closure of bladder rents during concomitant surgeries by our Surgical Gastroenterologists or

Andrology continues to hold its place of pride through many couples guided to lead successful marital lives by the correction of Erectine Dysfunction and / or infertility. Paediatric Andrology deals with correction of Short Penis, Micropenis, Hypospadias and Intersex.

Gynaecologists colleagues. Dr. T.R. Murali, HOD was invited as a Faculty for There is wide spread acceptance of PCNL and complete removal of the renal and upper ureteric calculi and a disillusionment with

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the APSSM conference at Singapore. He is also a Council Member from India for APSSM.


World class care within everybody's reach

Our Performance Ureteroscopy TURP TURBT Cystolitholapaxy Cystolithotomy Lap. Nephroureterectomy Lap.Adrenalectomy Nephroureterectomy Radical Nephrectomy Radical Cystectomy Radical Prostatectomy Bladder repair Pyeloplasty Urethroplasty Buccal Mucosal Urethroplasty Meatoplasty Ureteric reimplantation VVF PCN PCNL PCN gram PCNR Penectomy Penile biopsy EIU Hydrocelectomy Vasectomy Hypospadias correction Chordee correction Ureteroneocystostomy Orchidopexy Orchidectomy Herniorrhaphy Hernioplasty Renel Transplant Renal Donor Nephrectomy CAPD Catheter insertion AV fistula TVT Trucut biopsy DJS External Sphincterectomy Epididymectomy Dorsal Plication

597 178 52 63 2 18 5 2 35 6 1 94 18 10 4 23 8 6 94 77 112 85 2 4 100 10 3 27 1 1 23 39 11 5 18 16 39 143 10 30 318 13 1 1

CAPD Catheter Removal Epispadias repair Pyelolithotomy Mitrofanoff Ureterostomy Closure Inguinal BL dissection USG Guided aspiration Cystogram RGC Cyst excision SSG DJSR P. SCOPY MASSAGE Cystoscopy CMG MCU AUG FNAC Circumcision Endoscopic calibration Trocar SPC Urethral dilatation Bladder Biopsy BNI I&D Labial separation DIVU Laparascopic deroofing of cyst Wound Debridement PU Fulguration PCCL Fistula closure Lithotripsy

6 8 5 3 2 4 14 14 89 2 4 677 43 347 287 198 194 4 146 126 41 100 53 9 7 1 67 4 18 8 19 5 435

ANDROLOGY 21 37 33 6

EEJ Testicular Biopsy Varicocelectomy Penile prosthesis

In Patients

: 3202

Out Patients

: 10602

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World class care within everybody's reach

Cardiac Anaesthesiology

The initial mission of Cardiovascular Anaesthesiology is to develop a body of knowledge that would enable anaesthesiologists to improve survival and decrease morbidity of cardiac surgical patients. From PA catheters and Transesophageal Echocardiography to Thoracic Epidurals enabling fast-track anaesthesia for beating heart surgery, anaesthesiologists have kept pace with all the advancements in cardiac surgery by constantly re-inventing themselves, learning new techniques and mastering new technology. In our hospital, Cardiac Anaesthesiology has evolved over the past fourteen years. Our vision is to innovate and deliver high quality, cost effective anaesthesia care and pain management, to create a rewarding career for our staff, develop leadership in the field of cardiothoracic anaesthesia and cardiac rehabilitation.

Our performance The case load comprises approximately 498 cardiac procedures of which 346 represent patients undergoing coronary bypass grafting, 74 valve repair or replacement and 78 congenital procedures. This covers the entire gamut of cardiothoracic anaesthesia (i.e anaesthesia for Coronary Artery Bypass surgery, Valvular heart surgery, Congenital cardiac surgery and Thoracic & Vascular surgery). About 85% of our coronary revascularisation has been done on beating heart, which requires quality care anaesthesia and immense haemodyanamic monitoring.

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World class care within everybody's reach In line with the advancements in cardiac surgery,

during the perioperative period in our

our department performs valve repairs to

department to reduce wound infections and

suitable patients with good results. Cardiac

other co-morbidities. We are also actively

anaesthesiologists play a major role in

involved in the postoperative follow up of lifetime

performing peri-operative Transesophageal

glycemic control for cardiac surgery patients.

Echocardiography (TEE) therapy providing adequate assessment tailored to the pathology involved.

Cardiac Rehabilitation Cardiac rehabilitation was given special and

Highlights Transesophageal Echocardiography (TEE)

well-deserved attention this year. We have a dedicated Cardiac Rehabilitation team (includes a dietician and a physiotherapist) which takes

Few areas in cardiac anaesthesia have matured

care of the rehabilitative needs of the patient.

in recent past as much as the use of

Cardiac rehabilitation includes all measures

intraoperative

Tr a n s e s o p h a g e a l

used to help patients with heart diseases and

Echocardiography (TEE). It provides distinct real

return to an active and satisfying life without the

time images of the heart. An evaluation by TEE

recurrence of cardiac events. These services

may be required to obtain the most precise

include both the inpatients and out patients

information to guide surgical intervention (e.g.,

cardiac rehabilitation. The aim of this program is

myocardial revascularization, valvular

to educate the patients and emphasize the need

competence and repair of Congenital Heart

to apply an appropriate medical regimen in

Defects) and to guide pharmacological support

addition to the non-pharmacological treatment

and/or fluid administration in the perioperative

modalities of cardiac rehabilitation for maximal

period. TEE is the biggest leap in haemodynamic

benefit.

monitoring and is a useful tool in the hands of cardiac anaesthesiologist. In our hospital, TEE is

Facilities

used by the cardiac anaesthesiologist during mitral valve repair and heart failure surgeries and has become imperative for the successful outcome of these surgeries.

A well-equipped theatre with an invasive multi-channel monitor including monitoring of ETCO2 and Cardiac Output. Nine -bed ICU with multichannel

Management of Diabetes Although there is an evidence to suggest new

monitors, latest Ventilators, and IABP machines.

techniques like off-pump CABG and the use of

Trans Esophageal Echocardiography (TEE).

arterial grafts that have improved outcomes in

Dedicated,

diabetic patients than optimal treatment for

attendance, and each patient receives

multivessel CAD continues to evolve for the

individual care.

diabetic patient population, which despite improvements in revascularization still suffers

well-trained

staff

in

An anaesthesiologist is available round-theclock, and nothing is left to chance. This

from significantly worse outcomes when

assures adequate post-operative care of the

compared to the general population. Utmost

cardiac patients.

care is taken to maintain tight glycemic control

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World class care within everybody's reach Academic Activities

Membership in professional bodies

A host of academic activities form part of the

Life member – Indian Society of

calendar and ensures that the team is kept abreast

Anaesthesiology (ISA).

of the latest developments in anaesthesia.

Life member – Indian Society of Critical

Conferences / Workshop Attended Dr. S. Kumar, Cardiac Anaesthesiologist and Diabetologist

Care Medicine (ISCCM). Life member – Indian Association of Cardio Thoracic Anesthesiologists (IACTA).

May 2009 - The National Conference of Anesthesiologists 'IACTA 2009' and as a panelist in the discussion of 'Cardiogenic Shock in Acute MI- Management'.

Life member – Indian Medical Association

September 2009 – 'RSACP Con 2009' Research Society of Anesthesia and Clinical Pharmacology as a faculty in the discussion of 'Post CABG patients undergoing non-cardiac surgery'.

(IACTA).

October 2009 – Training program in Trans Esophageal Echocardiography (TEE) for a period of two weeks at Cleveland Clinic, OHIO, USA. November 2009 – Conference in the title “Standing Together Against Diabetes” by the American Diabetic Association at Dubai.

(IMA). Executive Council Member (National) – Vice President of ISA, Madurai City Branch. Joint Secretary of IMA, Madurai Meenakshi Branch.

Looming large on the horizon are the prospects of Minimally invasive cardiac surgery . Heart failure surgeries. Heart Transplantation. Key-hole Robotic Cardiac surgeries.

The way forward…. 'We are here to add what we can to life, not to get what we can from life.' - William Osler

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World class care within everybody's reach

Cardiothoracic and Vascular Surgery

The department of Cardiothoracic Surgery continues to provide national expertise in various cardiac procedures and vascular procedures. The total number of cases done in this year is 544. This covers the entire gamut of cardiothoracic surgery including Coronary Bypass Surgery, Valvular Heart Surgery, Congenital Cardiac Thoracic and Vascular Surgery. In Coronary Revascularisation surgery, the main emphasis is on Beating Heart CABG because this is a new and exciting development in the field with significant reduction in morbidity and cost. About 85% of our coronary revascularisation has been done on beating heart. To be exact, we emphasize on total arterial revascularisation to achieve better patency rate of the grafts. We undertake all high-risk cases with low ejection fraction, ventricular aneurysm, concomitant carotid stenosis and ischemic mitral regurgitation.

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In Valvular heart disease, apart from routine valve replacement, valve repair and Atrial Fibrillation ablation (Maze Operation) are also performed. Valve repairs by experienced surgeons have found to offer substantial advantage over replacements in terms of lowering the valve related complications. We, also offer valve repair to suitable patients and have shown good results. Our results with valve repair have been improved after attending various workshops at International centres. Trans Esophageal Echocardiography has been performed routinely by our cardiac anaesthesiologists & provides valuable support with encouraging results. In Congenital Heart Surgery, the common operations like ASD, VSD and PDA are performed routinely. We have also done highrisk complex operations like Total Correction of Tetrology of Fallot. In keeping with the latest trends in surgery, minimally invasive techniques are being increasingly applied. The amount of thoracic and vascular surgeries also contribute much to the quality outcome of the department. Our results have been very gratifying with internationally acceptable results. Even in emergency operations performed in patients with Cardiogenic shock, the department had shown good results. We are one of the few units in the country offering Endoscopic Vein Harvesting Technology to our patients at affordable cost.

Endoscopic Vein Harvesting

World class care within everybody's reach

zero infection rate. There is a ten-bedded ICU with all the latest gadgets available in any of the most developed centres in India. We have 3 Intra-aortic balloon pumps to salvage patients with Myocardial Infarction in Cardiogenic shock. An Endoscopic Tower has been procured for Endoscopic Vein harvesting.

Academic Activities The department has not lagged behind in academic activities. We regularly attend conferences and workshops conducted at National and International levels to keep pace ourselves with the current trends in Cardiac & Vascular Surgery. We conducted a workshop on 'Mitral Valve Repair' on 14th and 15th of September 2009, performed by Dr. Priyankar Sinha, Cardio thoracic surgeon from Ahmedabad. Conferences/ Workshops attended Dr. A. R. Raghuram, Consultant and Head of the Department

Facilities The operation theatre is dedicated to Cardiothoracic surgery with state-of- the- art facilities comprised of a seam-less stainless steel cladding of the walls, laminar airflow and a separate air-handling unit. This will maintain

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April 2009 - Workshop on “Mitral Valve Repair” by Dr. Tawaseek at The National Heart Institute, Thailand. October 2009 – Annual conference conducted by the European Association of cardio thoracic surgeons at Vienna, Austria.


World class care within everybody's reach Lectures delivered “Off Pump Coronary Artery Bypass Grafting in the Prof. Saratchandra Oration” held by the Association of Surgeons of India meet, Trichy. “Surgical Perspective of Congenital Heart Diseases” held by Indian Academy of Paediatrics, Thirunelveli. “Surgery For Valvular Heart Diseases” by the Association of Surgeons of India meet, Madurai branch.

Membership in professional bodies Life member - Association of surgeons of India. Life member – Indian Association of Cardio Thoracic Surgeons. Life member – European Association of Cardio thoracic Surgeons.

Publications An article on “Single stage repair of Coarctation of Aorta and Mitral Valve Replacement” has been submitted in the European Journal of CardioThoracic Surgery for publication.

The Future The future looks very encouraging. We share the dreams of our Chairman to perform Heart

Our Performance Off Pump Coronary Artery Bypass Grafting (Beating Heart CABG) Carotid Endartectomy On Pump Coronary Artery Bypass Grafting Combined Procedures Mitral Valve Replacement Mitral Valve Repair MVR + C.O.A. Repair+ Aneurysm Repair Aortic Valve Replacement Double Valve Replacement ASD Closure VSD Closure PDA Closure Intra Cardiac Repair Coarctation Repair Vascular Procedures Thoracic Procedures Others Mitral Valve replacement & Tricuspid valve repair Aortic Valve repair Closed Mitral Valvotomy Bental Operation Total

In Patients

309 1 18 19 33 12 1 13 6 58 5 2 7 1 22 12 8 7 1 1 2 544

:

769

Out Patients :

6462

Transplantation and Key-Hole Robotic Cardiac Surgery.

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World class care within everybody's reach

Cardiology

The Cardiology department comprises of 24 hours emergency services to manage the case of Acute Myocardial Infarction by Thrombolysis (or) primary angioplasty and its subsequent management to manage cases of congestive cardiac failure for stabilization and various other acute cardiac cases round the clock. The unit is well equipped with Critical Care Unit comprises of monitors and ventilators with computerized ECG, Tread mill test, Colour Doppler and 24 hours holter .

CATH LAB The department is equipped with two unique cardiac cath labs from GE INNOVA 2001 and SEIMENS medical system. The lab performs various diagnostic and interventional cardiac procedures. A team of specialists and Interventional Cardiologists are involved in performing the procedures.

Cardiac procedures in the Cath lab Coronary Angiogram. Right heart catheterisation. Coronary angioplasty/stent implantation. Ballon mitral valvuloplasty. Balloon aortic valvuloplasty. Balloon pulmonary valvuloplasty. Balloon tricuspid valvuloplasty. PDA coil closure. Temporary and permanent pacemaker implantation. Carotid angioplasty with distal protection device. Renal angioplasty. ASD / VSD device closure. 16


World class care within everybody's reach Facilities Available 1. IABP Intra Aortic Balloon Pump, which is a necessary equipment useful in patients with low blood pressure due to Acute MI or other causes for artificial maintenance of blood pressure in emergency situations.

Special Remarks Our Institute is well equipped to provide primary PTCA as a modality of Therapy in Acute Myocardial Infarction, in Tamilnadu. In the past, we have done reasonable number of Primary PTCA in AMI including those with IABP assisted Stenting.

Academic Activities 2. ACT Machine It can detect activated coagulation time to monitor the dose of Heparin particularly during PTCA and CABG. 3. TEE-Trans Oesophageal Echo A Diagnostic tool, to detect various cardio abnormalities particularly in the setting of any clot in heart, ASD device closure and assessment of prosthetic valve function and also during operative procedure to assist the surgeon. 4. STRESS ECHO This modality is useful to diagnose and prognosticate Coronary Artery Diseased patients. It is more sensitive and specific than Routine Tread Mill test, performed as Exercise Stress Echo (or) Obutamine Stress Echo.

The National Board of Examination has accredited our hospital to conduct 3 years course in Cardiology to award post – doctoral fellowship in DNB Cardiology. The cardiologists are updating their knowledge by regularly attending National and International conferences and also live workshops. Annual updates of all interventional procedures in the National Interventional Council of India. We perform 2300 Angiograms and 900 Angioplasties and 150 Balloon Mitral Valvotomies every year.

Coronary Angioplasty

5. Thallium (or) Techneitum Study We have well equipped Nuclear Medicine Department with SPECT camera for Thallium for Technetium 99 M.

We perform highest number of primary Angioplasty for Acute Myocardial Infarction covering Tamilnadu.

6. Sesta MIBI Myocardial viability assessment study.

We perform 2 vessel and 3 vessel angioplasty.

Other facilities include... Two well equipped Cath Labs. Colour Doppler Echo Cardiogram. Tread Mill Test. Computerized resting ECG.

We perform Angioplasty on critically ill patients with Intra Aortic Balloon Pump support. We offer both Bare Metal and Drug Eluting Stents for Angioplasties.

Holter monitoring. Cornary Care Unit (CCU). Hitech Cardiac monitors & Ventilators. 24 hours Emergency Ambulance Services.

Intervention for Heart Failure We are equipped to provide biventricular pacing as a treatment for heart failure.

17


World class care within everybody's reach Cardiac Catheterization with Oxymetry, Pressure Study and Angiogram for Congenital Heart Defects.

Procedure for Cardiac Arrythmias Electrophysiological study and Radiofrequency Ablation for various Cardiac Arrythmias.

Pacemaker Implantation

Implantable Cardiovertor and Defibrillator for prevention of sudden cardiac death.

Intervention for Valvular Heart Disease

Temporary Pacemaker Implantation on emergency basis. Single and Double Chamber permanent Pacemaker Implantation.

Miscellaneous Alcoholic Septal Ablation for HOCM EP study / RF Ablation.

Balloon Mitral Valvuloplasty. Balloon Aortic Valvuloplasty.

Non cardiac Procedures Balloon Pulmonary Valvuloplasty.

Aortogram. Cerebral Angiogram.

Intervention for Congenital Heart Disease

Renal Angiogram.

(CHD)

Peripheral Angiogram. PDA Coil Closure / Device Closure.

Mesenteric Angiogram. Renal Angioplasty/Stent Implantation.

ASD / VSD Device Closure.

Pe r i p h e r a l Implantation.

COA Balloon Angioplasty.

Therapeutic Vascular Embolisation.

Charity Work Correction of Congenital Heart Defects among underprivileged children is done free of cost & poor children are getting benefited under this programme.

Conferences and Workshops attended Dr. R. Sivakumar,

Senior Consultant and

Interventional Cardiologist

1.

National Interventional Council meeting at Hyderabad and presented an interesting case of Subclavian Angioplasty.

2.

Peripheral Angioplasty workshop at New Delhi.

Iliac and Femoral Angioplasty.

3.

Hands on training in Chronic Total Occlusion at Mumbai.

Below Knee Angioplasty.

4.

Clinical Trial meeting at Mumbai and gave a guest lecture on Management of Primary Pulmonary Hypertension.

Emergency pericardiocentesis to prevent death from cardiac tamponade.

5.

Tr a n s c a t h e t e r C a r d i o v a s c u l a r Therapeutics meeting, Sanfrancisco, USA.

Angiograms

6.

2 days training in pacemaker Implantation and CRT of Virtual Cath Lab in Chennai.

7.

National Endovascular workshop.

Intervention for Peripheral Vascular Disease Renal Angioplasty. Carotid Angioplasty.

Pericardiocentesis

Coronary Angiogram, Cerebral, Renal and Peripheral Angiogram. 18

Angioplasty/Stent


World class care within everybody's reach

Dr. S. Selvamani, Senior Consultant and Interventional Cardiologist 1.

April 2009 Asia Pacific TCT 2009 at Seoul, South Korea.

2.

September 2009 RT course at New Delhi.

3.

October 2009 TCT 2009 at Sanfrancisco USA.

4.

November 2009 Indo European conference on Revascularisation.

Dr. N. Ganesan, Senior Consultant and Interventional Cardiologist 1. April 2009 – OPAL 2 Investigators Meet at Singapore. 2. May 2009-EURO PCR, Interventional Conference Barcelona, Spain. 3. September 2009 Clinical Observationship at Cleveland Clinic, Ohio, USA. 4. September 2009 TCT 2009 Interventional Cardiology conference San Francisco, USA, presented a challenging case of Multivessel stenting. 5. December 2009 ISE Madurai Conference.

Our Performance Coronary Angiogram PTCA Balloon Mitral Valvotomy Permanent Pacemaker Implantation Lower Limb Angio Cerebral Angio Renal Angioplasty LABP Pericardial Tapping Temporary Pacemaker Implantation Cardiac Catheterisation Peripheral Angiogram Peripheral Angioplasty PDA Coil Closure PTBD ASD Device Closure IVC Filter Renal Angiogram Balloon Pulmonary Valvotomy Balloon Aortic Valvotomy ICD E.P.study Others Total

2334 913 149 47 6 7 10 47 18 73 27 4 3 16 18 8 4 10 8 6 2 9 7 3726

In Patients

:

2902

Out Patients

: 13141

19


World class care within everybody's reach

Dental and Maxillofacial Surgery

As the demand and need for conservative dentistry increases this year we added the vision towards preventive and conservative dentistry. Our department is glittering with the hi-tech equipments and sophisticated Dental Unit. We are equipped with endomotor and apex locator for precise root canal treatment. For perfect diagnosis we are equipped with digital RVG

[Radio Video Graphy] with DC X-ray unit which is the best of its kind

because of its minimal radiation exposure and accurate digital interpretation.

Treatment Facilities Routine dental treatment procedures

Removable partial dentures.

Extraction.

Complete dentures.

Oral prophylaxis – scaling [dental cleaning and polishing].

Fixed crowns and bridge dentures.

Tooth colour filling and other aesthetic restoration. Periodontal procedure.

20

Removable orthodontic appliances.


World class care within everybody's reach Awareness programmes

Specialized Treatment Procedures Root canal treatment using endomotor, RVG and Apex locator. Dental implants. Correction of abnormally positioned teeth by orthodontics [fixed / removable / surgical correction] We do the latest MBT fixed orthodontic procedure. Facial cosmetic surgery. Management of impacted teeth and related problems.

Free dental camps for general public are being held every Wednesday from morning 9.30 am 1.30 p.m. in the dental OPD. Regular dental camps are conducted in schools and colleges for dental screening and oral hygiene education, in and around Madurai District.

Our Performance In Patients

:

244

Out Patients

: 3319

Dento alveolar surgeries. Maxillofacial trauma and fracture surgeries [maxilla, mandible, zygoma, alveolus etc.,]. Surgical management of cysts in the jaws. Endodontic surgery – apicectomy. Management of various neurologial problems of the orofacial regions. Management of dental and orofacial infections. Management of temporomandibular joints and related problems. Management of salivary gland associated dysfunction. Periodontal and gingival surgical procedure. Single visit complete dentures. Management of oral cancers. Paediatric dentistry. Geriatric dentistry. Cosmetic / cosmogenic dentistry. Dental management in pregnancy. Dental management of compromised patients Eg. hypertensive, asthmatic, cardiac, mentally and handicapped patients.

medically Diabetic, epileptic, physically

21


World class care within everybody's reach

Dermatology and Venereology

The Various routine daily procedures the in our department are listed below

Co2 laser

Psoriasis Erythroderma Vitiligo Removal of warts, DPN, mole

Co2 laser scar revision

Acne scar

Q-Switched Nd: YAG laser

Tattoo removal, Freckles Nevus of Oto, Post Inflammatory Pigmentation

Micro dermabrasion

Acne Scar, Facial Rejuvenation

Cryo Therapy: Liquid nitrogen nitrous oxide

Molluscum contagiosum, corn feet Keloids

Diode laser

Hirsuitism

Chemical peeling

Melasma, Acne

Tattooing

Vitiligo, Post Inflammatory De Pigmentation

Biopsies: punch, needle

Psoriasis, LP, Vesiculobullous diseases

Piercing gun

Ear and Nose stud piercing

PUVA Chamber: PUVA therapy NBUVB therapy

22

The Department of Dermatology, Cosmetology and Venereology deals with various dermatological procedures apart from accurate diagnosis of even troublesome acute and chronic disease.

Our Performance In Patients

:

151

Out Patients

: 8648


World class care within everybody's reach

Diabetology

Diabetic out patient clinic is providing medical care to the diabetic people with our mission of providing World-class care within every body's reach. Every one knows the magnitude of diabetic burden in our nation. By 2030, the burden will affect not only the individual but also the nation's health budget. To overcome this, we have to initiate primary preventive measures like life style modification and awareness programmes.

Achievements We have achieved many things as what we promised in our last year.

Diabetic Club We started diabetic club on June 2009. About 450 diabetic patients were registered. Every month, awareness lectures and screening for diabetic control and complications were done free of cost.

Diabetic Foot Wear Every one is aware that diabetes is the leading cause for non-traumatic amputations in the world. To prevent diabetic foot ulcer, we started appropriate footwear for the diabetic patients. We also provide custom made footwear like heel free/ fore foot free and rocker bottom footwear, which is made up of Micro Cellular Polymer (MCP). We conduct awareness cum screening programmes for various groups of people in and around Madurai to improve the knowledge about diabetes.

23


World class care within everybody's reach

Conferences attended

Awareness Programme Some of the programmes include... 1.

CECRI

- Karaikudi

2. 3. 4.

ICICI Bank Depositors CMFRI Auto Driver Camp at Susee Auto Home Needs Exhibition at Tamukkam

- Madurai - Tuticorin

5.

- Madurai - Madurai

World Diabetic Day On Nov'14 - 2009, World Diabetic day was celebrated in our hospital. There were about 160 people underwent diabetic special package (Rs 300/-) and participated in the discussion with the consultations from other specialities like Cardiology, Neurology and Urology.

Free Insulin Scheme We are providing free insulin immunization to type 1 diabetic children under the age of 18yrs with the Novo aid programme. At present, six children are getting free insulin in this scheme.

1. Outcome Research Methodologies in Diabetes

- Delhi

2. Diabetes Asia 2009

- Kualalumpur

3. RSSDI 09

- Ahamedabad.

4. Steno Diabetes Star Course

- Jaipur

5. Investigator Meeting -TAKEDA

- Delhi

Publications and presentations 1. Stress Hyperglycemia in Head injury subjects - oral presentation in Diabetes Asia-09. 2. Poster presentation in RSSDI 2009Stress Hyperglycemia in head injury subjects.

Diabetic Health Check Up Package There are two-health check up packages for diabeties in our hospital. Comprehensive Diabetic Health Check Up

: Rs. 1500/-

Comparing with last year, this year we did health checkup for more than 100 patients to provide total diabetic care under one roof. Special Diabetic Package

: Rs. 500/-

We introduced new diabetic benefit of lower economic package, we are focusing glycemic control, diabetic nephropathy screening.

package for the groups. In this mainly on diet, retinopathy and

Research 1. For the very first time, Institute of Diabetology, took Phase III trial in MMHRC. 2. More trials are yet to initiate in the coming year.

24

Our Performance In Patients

:

182

Out Patients

: 7045

Future Plans 1. Diabetic Foot Clinic / Podiatry Care. 2. Insulin Pump Therapy. 3. Continuous Glucose Monitoring System (CGMS).


World class care within everybody's reach

General Medicine

The Department of Medicine offers treatment for all problems. The Intensive Medical Care Unit (IMCU) is equipped with state – of – the – art equipments manned round the clock by medical personnel. It is one of the core departments of the hospital and has treated & admitted maximum number of patients. It functions by eminent Consultants, Senior Medical Officers, Post Graduate Students, and Researchers under the Leadership of Prof. V.N. Rajasekaran.

Hypertension Clinic The Hypertension clinic focuses on early deduction, complete investigations and proper management of Hypertension. The importance of stress management, changes in the life style, periodic regular checkups, proper compliance in taking the drugs regularly is stressed upon the patients. The role of non-drug therapy such as food modifications and regular exercises is also emphasized. Special investigations like C.T.M.T., Angiography and Hormonal estimations are also performed whenever necessary.

Geriatric Clinic This caters to problems of senior citizens. In total, the Department has treated 18,752 out patients and 3,211 in patients for various diseases.

25


World class care within everybody's reach Asthma and Allergy Clinic

3. Allergy and Immunotherapy.

The clinic focuses on identifying possible allergens and offers vaccination therapy wherever indicated. The pulmonary lung function test equipment assess the functional capacity of the respiratory system. We are running an Asthma Club whose members meet once a month to discuss on various day to day difficulties in asthma management and management of challenges faced in chronic diseases.

4. Comprehensive Asthma Care Clinic. 5. Tuberculosis Clinic. 6. Pleural Biopsy by Abram's and Cope's Pleural biopsy needles. 7. FNAC lung and Tube Thoracostomy. 8. Lung Biopsy. 9. Diabetes & Foot care.

Respiratory Medicine The following diagnostic and therapeutic procedures are being done at the chest clinic. 1. Flexible fiberoptic Bronchoscopy: Performing about 3000 Bronchoscopies and various difficult diseases have also been diagnosed and managed on few occasions. Our hospital is catering to the need of many patients covering all the southern districts of Tamil Nadu in the field of Bronchoscopy. 2. Computerized pulmonary function test.

Major & Minor Procedures 1. Bone Marrow Aspiration. 2. Lumbar Puncture. 3. Pleural Aspiration. 4. Liver Aspiration. 5. I.C.D.Procedure. 6. Diagnostic Tapping. 7. Liver Biopsy Procedure.

Our Performance All types of fever All types of Neoplasms Circulatory Diseases Digestive System Endocrine, Nutrition and Metabolic Disease Genito Urinary Disease Hematological Disease Mental Disorders Nervous Systems Respiratory Disease Others

26

-

7270 3992 6555 4151

-

5195 794 2126 1409 1276 4063 4487

In Patients

: 3211

Out Patients

: 18752


World class care within everybody's reach

Imaging Science and Interventional Radiology first prize in a quiz competition conducted by Barnard Institute, Chennai on December 2009a nation wide CME on imaging for women's health. Dr. Jaishree and Dr. G. Arthi residents from radiology won third prize in National Pa e d i a t r i c R a d i o l o g y conference for poster presentation held at Chennai by Target Foundation.

Diagnostic and therapeutic procedures The department has been showing a steady growth for the patients imaged and treated with interventional procedures. We have recently installed 3D Rotational Angiography in the field of neuro interventions. The most awaited 1.5 tesla MRI would be installed very soon in the near future.

Academic Activities

Diagnostic Angiographies. Embolization of Uterine, Bronchial , Hepatic, Renal and peripheral arteries. Peripheral Angioplasty and stenting.

In regular alternate days, teaching programmes, weekly journal club, quiz programs and MRF meetings etc will boost the confidence of DNB residents facing their exams.

CT and ultrasound guided Biopsy and aspiration.

PGs are encouraged to attend conferences all over the country & are informed to face the challenges of Teleradiology programme started recently to offer online reporting and teleconferencing programmes.

Carotid and Renal Angiography and stenting.

People are welcome to undertake training and short term courses on various modalities of CT, MRI and Basic Interventional Radiology techniques also.

Academic achievements First prize in open quiz competition on Spiral CT-Scan at National conference held at Goa in September-2009. Dr.N.Karunakaran and his team with resident Dr.Jaishree got

Mammography Biopsy. Hepato biliary interventions PTBD, Stenting. Radiofrequency ablation of Tumours. 27


World class care within everybody's reach Real time 3D ultrasonography guided Biopsies.

Ultrasound Colour Doppler

Image guided neruolysis for Chronic pain.

CT coronary angiography.

Equipments X-ray machines –Ranging from 20 – 800 MA.

743

Doppler procedures

2912

Doppler studies of

Vertebroplasty. Endosonography guided Biopsy and drainage.

Echocardiography

various organs

6703

Routine U/S imaging

12313

3D ultrasonography

19

Routine CT scans

7252

CT guided procedures

231

Coronary angio.

182

MRI

1569

EUS

761

Mammogram

869

CT

Image Intensifier.

Conference workshop & attended

Mammography. Voluson E8 – high end 4D whole body color Doppler. Logic 5 -Color Doppler. Logic E book portable color Doppler ultrasound.

Dr. T. Mukuntharajan, Senior Consultant, Head of the Department

1. ISVIR National Meet, Mumbai Invited Faculty. 2. RAIN, Chennai. 3. DVT Investigator Meet, Malaysia.

INNOVA 2100 3D Cath Lab. Seimens Axiom Artis U Cath Lab. Computed radiography.

Dr. N. Karunakaran, Consultant 1. Head And Neck Imaging - Target Chennai.

Multi slice CT scanner. Open MR system.

2. Paediatric Radiology Annual Conference - Chennai

Endoscopic ultrasonography.

3. MRI Update - Mumbai

Our performance Dr. R. Ganesh, Junior Consultant

Radiology Routine X-rays Contrast studies like IVU and Barium etc,

64119

1. Musculoskeletal Radiology Review Course - Mumbai

757

2. Dr. Harnam Singh Mid Term CME Chennai

155

3. Spiral CT Update – Goa.

Inverventional radiology Angiographies Angioplasties and Stenting, Embolisations Drainage procedure and Biopsies

28

66

Meeting Conducted 780

Monthly Radiology CME.


World class care within everybody's reach

Intensive Respiratory Care Unit ( IRCU )

This critical unit operates with the strength of 11 cubicles, assures maximum isolation, barrier nursing, privacy and sterility, providing intensive care and high dependency care with the aid of appropriate pharmaceutical, therapeutic, diagnostic interventions with modest technical backup.

The new configuration Provision for Neonatal Mechanical Ventilation by dedicated team at Neonatal ICU.

Our technical arsenal Sophisticated monitoring devices, drug delivery systems, and new generation of Mechanical Ventilators aided by smooth man-machine interactions.

We take pride in Vigilant and dynamic monitoring motivated and guided by a team of full time Anaesthesiologists, delivering excellent patient care with human touch.

29


World class care within everybody's reach We indulge in Enhancing practical skills in handling complex equipments, monitoring procedures and performance of invasive techniques. Enhancing clinical skills in recognizing, preventing and managing critical illness, infection control and organ support.

Our collaterals Trained Physiotherapy Unit. Dieticians. Biomedical backup. Family Counselling / Psychiatric Consultation for patients with attempted suicide.

Our key to success Patient centred comprehensive, multidisciplinary care with coordinated, collaborative and cost effective approach in a compassionate and healing environment.

30

We deliver Advanced Mechanical Ventilatory Therapy including Non-Invasive ventilation. Neonatal Ventilation in dedicated Neonatal ICU. Diagnostic and Therapeutic Fiber-Optic Bronchoscopy. Percutaneous Dilational Tracheostomies. C e n t r a l Ve n o u s a n d A r t e r i a l Cannulations and Temporary Cardiac Pacing. Mechanical Ventilatory support for PostOperative and Polytrauma patients. Management of complicated OrganoP h o s p h o r u s Po i s o n i n g s w i t h encouraging and successful outcomes. Orientation, teaching and training programmes for medical and paramedical personnel.

Our Performance Total no of admissions

:

1018

I) Adult

:

926

ii) Paediatric

:

92

Total no of patients on Ventilator

:

905

Total no of poisoning patients

:

194

Total survival rate

:

88%

Survival rates - Ventilated patients

:

84%

Survival Rates - Poisoning Patients

:

98%


World class care within everybody's reach

Laboratory Services

During the financial year 2009-2010, there was a substantial increase in the workload of all the departments within the laboratory unit. The Haematology department procured a new equipment. One was the Beckman Coulter LH500, which was introduced as a second fully automated heamatology analyzer due to the heavy workload in the department. We also went in for a fully automated coagulation analyzer, the first of its kind in South Tamilnadu. It is the ACL ElitePro from Instrumentation Laboratories (IL). In this equipment, we can run additional tests such as all factor assays, D-dimer, and other coagulation parameters which are at present not being done by automation anywhere in Madurai.

31


World class care within everybody's reach In Biochemistry, we have introduced new parameters, Methaemoglobin and 24 hours Urine Citrate.

Academic Activities 1.

Provided handouts and served as a project guide for M.D pathology students of Madurai Medical College at Urology Department in the topic Cytology Correlation for Bladder Lesions.

2.

Biotechnology students in PR Engineering college Thanjavur Anna University, Chennai in concurrence with Surgical Gastroenterology Department. Topic – Immunohistochemical Spectrum of GISTS at different sites and their differential diagnosis with a reference to CD 117 (KIT).

Pathology Pathology deals with processing and reporting of biopsy samples (small and large), FNAC, Cytology and cervical Pap smears. Reporting of bone marrow aspirate, peripheral smear, LE cells test are done. We are also doing frozen sections for difficult intra operative cases. Immunohistochemistry is being done for difficult and rare cases. Hormone receptor status ER PR Her2 for Breast Cancers. Fat laden macrophages for EPS.

Special Features

3. Provided reports with microphotographs for academic purpose. 4. Conducted theory and practical classes in pathology for final year B.Sc [MLT] students of our hospital, Fathima College, Madurai and National Institute.

1.

Fully automated tissue processor for processing.

2.

Automated knife sharpener for thin sections.

3.

Special stains for A-AFB, B-FUNGI, and C-OTHER STAINS.

4.

C y t o c h e m i c a l s t a i n s ( E G ) PA S, Myeloperoxidase, LAP.

Our Performance

5.

Immunohistochemistry.

1.

Biopsy (small and Large)

-

4739

6.

Frozen section.

2.

Cytology & FNAC,EPS

-

1134

3.

Special stains (PAS, Reticuline, Mpo, LAP)

-

10

4.

Immunohistochemistry

-

415

5.

Frozen section

-

4

6.

Pap smear and camp pap smear

-

2670

7.

Peripheral smear

-

3616

8.

Bone marrow

-

246

9.

LE Cells

-

5

-

137

5. Regularly provided handouts for clinical meetings and papers presented by various departments.

10. ER, PR And Her2

32


World class care within everybody's reach

Medical Oncology

The department deals with diagnosis, treatment, health education, prevention and rehabilitation of cancer patients. We treat patients with chemotherapy (drugs). Cancers like Leukemia, Lymphoma and Myeloma and other solid tumours in breast, gastro intestinal tracts, ovary and paediatric tumours are also treated. Combined modality treatment has become the gold standard in the treatment of cancer. So Chemotherapy along with Radiotherapy and surgery has not only increased the response rates of treatment but survival rates also has also increased with good amount of quality of life. The treatment options of each patients are discussed in the tumour board which comprises of Medical Oncologists, Surgical Oncologists, Radiation Oncologists and Pathologists. The department works in harmony with the other departments to ensure proper patient care. Most of the chemotherapy almost 70-75% are being given in the day care room. It has become very convenient for the patients that they need no admission. They can finish the chemotherapy procedure in 4-5 hours time and get back to their home. Lot of new drugs is available in these recent days, showing good results. We are also using drugs which are available in oral form with a very good response rates at various clinical settings.

33


World class care within everybody's reach Last year clinical trials have increased in numbers. This has been a boon to the patients who have no treatment for their diseases. Some of the drugs has shown good response rates, which looks really promising and is a welcome situation in India for the cancer patients. Bone Marrow Transplantation would be initiated in the coming year in our hospital. Prime Minister & Chief Minister Relief Fund are available for poor patients. Health education is provided to patients and patients attenders and counselling to increase the awareness of cancer. Indications for Clinical Trials :

34

1. Docetaxel BE

Ongoing

2. Paclitaxel BE

Ongoing

3. CapecitabineBE

Ongoing

4. Pancreas Cancer I

Ongoing

5. Mantle Cell Lymphoma III

Ongoing

Our Performance

6. Chemotherapy induced Neutropenia in MBC III

Yet to start

7. Breast Cancer III

Yet to start

Day Care Chemotherapy Medical Oncology

-

424

Gynaecology

-

2

Orthopaedics

-

1

Radiation Oncology

-

83

Surgical Oncology

-

57

Reproductive Medicine

-

1

Total

-

568

In Patients

: 1357

Outpatients

: 4336


World class care within everybody's reach

Nephrology

The department of Nephrology has grown to become one of the largest Nephrology centres in India. This year, modernized Haemodialysis unit has been commissioned with a centrally air conditioned HD unit [unit A & unit B] with 20 new HD machines and a CRRT machine. GE Osmonics is providing ultra pure water through new RO Systems. In our Interventional suite, we perform our surgical procedures. At CAPD Room, we do pre dialysis counselling and CAPD exchanges. We have been treating largest number of out patients in our hospital for the last four years with an average of 80 per day. Every year 20% increase in patient load and growth in all fields of nephrology. The department has become a tertiary referral centre in the management of high risk Nephrology cases under the leadership of Dr. K. Sampath Kumar, Consultant and Head of the Department.

Haemodialysis Programme We are one of the largest HD units in south India with modern Dialysis machines BBraun, Fresenius, Kawasumi, Gambro and Cobe. The Haemodialysis unit contains treatment area A &B with 20 machines. We have separate machines for HCV and HBsAg infected patients. Now we perform around 1200 Haemodialysis/per month. In our 24hrs Haemodialysis program, we are planning to start nocturnal longtime Haemodialysis in the coming year. The state of the art Osmonics Water Treatment system is installed to improve the already high standard of care in haemodialysis. Plasmapharesis and acute peritoneal dialysis including automated cycle exchanges is performed regularly. We are doing intensive care dialysis in the form of CAVH, CVVH, SCUF, CVVHDF and SLED for patients with Liver, Heart and Kidney failure patients even if the blood pressure is low. Our renal dietician takes care of the nutritional aspect of our ESRD patients. Maintenance of dialysis patients are enrolled in our deceased donor transplantations [cadaver transplantations]. 35


World class care within everybody's reach Continuous Ambulatory Peritoneal Dialysis

Interventional Nephrology

(CAPD) Programme

Our hospital can be considered as the capital of Interventional Nephrology in India. We have a dedicated Interventional team. All interventions are done in our mini theatre called Interventional suite, adjecent to the dialysis Room. We regularly perform Tunneled Internal Jugular catheters [Perm cath] in our Interventional suite. The first live interactive Interventional Nephrology workshop of India was organized at Kanyakumari under the Southern Chapter of Indian Society of Nephrology headed by Dr. K. Sampath Kumar.

First CAPD at our hospital was done in the year 1996. Now for the last 13 years we have initiated around 160 CAPD catheters with good success rate. We started percutaneous CAPD catheter insertions in the year 2007 since then we have introduced around 60 percutaneous CAPD Catheters. Baxter PD Centre established in 2006 December with an aim of counselling pre dialysis patients for CKD management, life style modifications, diet, treatment planning etc. A Video CD which narrates CRF treatment choices in local language [Tamil] was released which is the first of this kind. Every six months we conduct patient’s meet which is a good platform for our patients to interact with each other. Automated PD was started in 2004. The success of CAPD is measured by the lack of infection. In our patients, the peritonitis rate is 1 in 36 patient months which is comparable to international standards.

Renal Transplantations Our centre is one of the leading Transplant centres in South India with an excellent success rate. The first Transplant was done in the year 1991 and till now around 350 renal transplantations were done. A separate ICU for post renal transplant care with 4 beds has been commissioned this year. Latest protocols for post operative immunosuppresion is followed with prompt drug level monitoring which can be done in our well equipped lab. The surgical team has performed laparoscopic donor nephrectomy ushering in the era of shorter hospital stay and less painful surgery to the donor. Renal allograft biopsy is routinely done in our centre. Recently, Cadaver transplantation was given a boost and our urology team has carried out 7 cadaver transplants successfully. The first ever multiple organ procurement from a deceased donor in southern district of Tamil Nadu was carried out this year.

36

Renal Intensive Care Unit [RICU] This year we started a new air-conditioned intensive care unit with state of the art monitors with eight beds for treating critically ill patients. We have all hitech monitoring systems and devices for dialyzing critically ill patients. RICU is equipped with continuous supply of RO Water for emergency Haemodialysis. Expert doctors, well trained renal nurses, physiotherapist and renal dietitian monitor the unit.

Our department towards charity.... Following our Hospital’s vision, 1)

All our regular HD patients are getting One Free HD per Month.

2)

Free Procedure Charge for Central venous lines- For Regular HD Patients.

3)

We provide free Dialysers and Blood lines for the needy.

4)

We are planning to provide free renal diet during Dialysis.

5)

Provision of free CAPD catheters for paediatric CAPD programme .

Kidney Donor’s meet Our hospital and MOHAN FOUNDATION together conducted a kidney Donor's Meet in which 43 donors participated with their families. In this meeting, we honoured the family members who donated their organs to their loved ones.


World class care within everybody's reach Academic activities DNB Training Programme The Department is recognized by National Board of Examinations, New Delhi for conducting Nephrology Super Speciality training programmes since 2005. Our first candidate Dr. YS. Sooraj was the only one candidate in Tamilnadu to pass in first attempt among the seven in India. We are getting High quality aspirants for PG training every year. We have published more than 10 articles in peer reviewed National and International Nephrology journals and presented papers in conferences all over the world. Regularly we conduct case discussions, Lectures on various issues, clinical pathology, Topic discussions, Journal reviews etc. Monthly, we execute HD table rounds, CAPD table rounds, MANUS presentation and we also organize clinical society and medical audit. Yearly, periphery posting is done in Radiology & Imaging sciences for one month and seven days training programme in Beijing University.

Renal Nursing Programme We have a regular nursing programme every month to train our new staff and special classes on BLS and ACLS every six months. We are using CQI index to evaluate the work quality of our staff. We used to conduct regular CME programs for our PG's, General Practitioners and Referral Doctors.

Library Services Regular subscription of all important Nephrology journals like Kidney International, JASN, AJKD, Nature Nephron, NDT, Nephrosap etc.The entire department is free Wi-Fi zone. All academic and department activities take place in the library hall. which is equipped with LCD Projector and a Binocular Teaching microscope for the students.

Recent Publications 1. Dr. Sampathkumar K, Dr. Sooraj YS, Dr. Ajeshkumar RP, Dr. Mahaldar AR, Dr. Muthiah R. - The Case of Acute

paraplegia with anuric ARF. Occlusive aortic thrombus with ischemia of spinal cord and kidneys.(Kidney Int. 2007 Sep;72(5):657-9) . 2. Dr. Sampathkumar K, Dr. Murali TR, D r. S o o r a j Y S , D r. M a h a l d a r AR. - Emphysematous prostatitis in renal transplant. (Indian J Urol 2007; 23:476-8). 3. Dr. Sampathkumar K, Dr. Sooraj YS, Dr. Ajeshkumar RP, Dr. Mahaldar AR, Dr. Muthiah R-Rhabdomyolysis due to hair dye poisoning: An emerging threat. (Indian J Crit Care Med 2007;11:212-4) 4. Dr. Sampathkumar K, Dr. Mahaldar AR, Dr. Sooraj YS, Dr. Ajeshkumar RP, Dr. Muthiah R-Milk Alkali Syndrome-Old Wine in a New Bottle. (I journal of peritoneal dialysis April 2007, 41-43). 5. Dr. Sampathkumar K, Dr. Mahaldar AR, Dr. Sooraj YS, Dr. Ajeshkumar RP, Dr. Muthiah R - Percutaneous CAPD catheter insertion by nephrologist. (I J Nephrology April 2008). 6. Dr. Sampathkumar K, Dr. Sooraj YS, Dr. Ajeshkumar RP, Dr. Mahaldar AR, Dr. Muthiah R-lathanum deposits in colon-a new phenomenon (I J Nephrology April 2008). 7. Dr. Sampathkumar K, Dr. Sooraj YS, Dr. Ajeshkumar RP, Dr. Mahaldar AR, Dr. Muthiah R-Jouberts syndrome with renal failure. (Kidney International, 2008). 8. Niacin for phosphate control – perspective from a developing country by Dr.K.Sampathkumar (International Urology and Nephrology journal, November, 2008). 9. Hair dye poisoning – An emerging threat in the developing country by Dr.K.Sampathkumar, Dr. Sooraj YS. (Journal of Emergencies and Trauma. February, 2009). 37


World class care within everybody's reach 10. Granulomatous Interstitial Nephritis due to Renal Tuberculosis - Dr. Krishnaswamy Sampathkumar, Dr. Sooraj YS, Dr. Amol Mahaldhar, Dr. Ramakrishnan, Dr. Ajesh Kumar. (Saudi Journal of Kidney disease and transplantation. 2009). 11. Is there an urban rural divide in the CAPD results. (Indian journal of Peritoneal dialysis.June 2009.) by Dr. Amol Mahaldar, Dr. Sampathkumar, Dr. Ajesh Kumar, Dr. Ramakrishnan. 12. Angiotensinogen gene polymorphism in South India dialysis patients- Journal of Clinica Chimica Acta 406 (2009) 108–112 .

Our Performance

13. ANCA negative glomerulonephritis with systemic involvement- Accepted for Indian Journal of Nephrology, 2010.

Haemodialysis

-

12652

Free Haemodialysis

-

436

Renal Biopsy

-

124

Plasma Pharesis

-

12

AV. fistula

-

93

CAPD

-

15

Renal Transplant

-

26

Nephrology Society Honours & Recognitions

CRRT

-

46

Our Head of the Department Dr. K. Sampath Kumar is the present Honorary Secretary of Indian Society of Nephrology, Southern Chapter. He has brought out the first Newsletter for this Nephrology Association. He is currently the Associate Editor of Indian Society of PD Journal.

Peritoneal Dialysis

-

20

PERM Catheter

-

50

14. Norwegian scabies in renal transplant patient- Accepted for Indian journal of Nephrology, 2010.

In Patients

:

2159

Out Patients

: 22963

Future Plans 1. Planning to start Dialysis Technician Course. 2. Tie up with other centres of excellence abroad. 3. Collaboration with International Society of Nephrology for Sister Renal Unit Program. 4. Collaboration with International Society of Peritoneal Dialysis for Academic Exchange Program. 5. Setting up a Renal Research Cell for South Indian Kidney diseases.

38


World class care within everybody's reach

Neurology The Neurology department has come a long way for the past15 years from infancy to a Neurology teaching department with DNB training. It has EEG, EMG, VEP, BAEP, Nerve condition, muscle disease diagnosis with a supportive pathology lab. Most importantly it has established a well-equipped sleep lab and obstructive sleep apnea treatment protocol. We have come leap and bounds in stroke management. We have a good intra cranial tension management protocol medically which includes life saving surgery in coning due to massive stroke. This is supported by good stroke unit with good GCS monitoring, vitals monitoring with prevention of DVT, bedsore. There is also provision for intravenous and intra arterial thrombolysis. So we acquire good recovery from stroke in par with best hospitals in India. There are various protocols to reduce the post – stroke disability with functional improvement including good physiotherapy unit, botox therapy etc. In outpatient management each and every complaint of patients are analyzed, accompanied by good examination.

Our Performance EEG and Video EEG Nerve Conduction study Carpal Tunnel Decremental Response EMG Facial Nerve Conduction Visual Evoked Potential Brachial Plexus PASG BERA

: : : : : : : : : :

600 157 10 3 10 10 1 3 32 39

In Patients

:

800

Out Patients

: 6149 39


World class care within everybody's reach

Neuro Surgery

The department of Neurosurgery is now becoming the centre for effective treatment of complicated neurosurgical problems. Most of tumours whether spinal or brain tumours are referred to our department. For complicated tumours in patients, we have maintained nil mortality and very low morbidity this year because of microneurosurgical techniques. The most complicated tumour which we operated this year was a Glomus Jugulare (paraganglionoma of lower cranial nerves) for 12 hours and the patient is fine now. We have aquired neurosurgical drill system which helps in handling complicated cases. We provide comprehensive head injury care with 80% survival rate which is one of the best in the world. We are able to achieve this success with the support of our dedicated staff to team. Our department regularly conducts endoscopic surgeries for Pituitary tumour and CSF Rhinorrhoea, Microneurosurgery for Aneurysm and AVM, spinal fixation procedures, paediatric neurosurgical procedures. In short, the whole gamut of neurosurgical procedures are done under one roof. We conducted an Annual CME Programme “Neurocon 2009� in October. 100 doctors from South Tamilnadu participated. Conferences / Workshops attended Dr. Karthikeyan, attended Skull Base conference at Hyderabad on September 2009.

40


World class care within everybody's reach

Our Performance Trauma

-

134

Tumour - Supratentorial

-

46

Tumour - Infratentorial

-

10

Spinal - Tumour

-

9

Spinal - Abscess

-

3

Spinal - TB

-

2

Spinal Trauma

-

3

Lumbar Disc

-

9

Cervical Disc

-

6

Aneurysm

-

2

Trauma - Cervical

-

2

Hypertensive ICH + Infarct

-

14

Chronic S.D.H

-

40

V.P. Shunt

-

45

Cranioplasty

-

5

Meningomyelocele

-

3

EVD

-

7

Endoscopic CSF Leak Repair

-

6

Others

-

41

Total

-

385

In Patients

:

1270

Out Patients

:

4999

41


World class care within everybody's reach

Nuclear Medicine

This is relatively a new branch of imaging science concerned with the FUNCTIONAL EVALUVATION of various organ systems of the body. The procedure is very simple, whereby appropriate radiopharmaceuticals are injected intravenously and emitted gamma rays (similar to X-rays) are detected by means of a gamma camera.

Some of the well known applications of Nuclear Medicine includes... Estimation of individual kidney/ split function, Differentiation of non-obstructive from obstructive hydronephrosis, Screening for skeletal secondaries in patients with known malignancies prone to disseminate to the skeletal system (ex. CA Prostate, CA Breast), Assessment of inducible ischemia and viability, Detection of ectopic gastric mucosa, Function evaluation of thyroid gland and Detection of ectopic thyroids. Therapeutic applications of nuclear medicine includes treatment of hyperthyroidism and post-operative ablation of remnant thyroid tissue / differentiated secondaries in patients with differentiate carcinoma of thyroid.

Our Performance Out Patients Diagnosis Scans Low Dose Iodine Whole Body Scans Low Dose Iodine 131 therapy for hyperthyrodism High Dose Iodine 131 therapy for differentiated carcinorma of thyroid (Post Operative)

}

42

: :

1244 935

:

193

:

68

:

44 (Inpatient Procedures)


World class care within everybody's reach

Obesity Clinic

Our Performance Out Patients : Review

199

: 131

Obesity clinic is functioning since March 2009. We are giving world-class medical care & counselling for obesity / over weight people. 70 Millions of Indians are over weight and 30% of population are suffering with obesity induced diseases like hypertension, diabetes type II, cancer and osteoporosis. 15% of children are obese in India but awareness about Obesity induced diseases are lacking. To overcome this difficulty, we have initiated awareness programme in schools and public medias like Radio, TV Channels and conducting seminars in voluntary organizations.

Awareness Programmes 1. We conducted awareness program for different groups of people in & around Madurai. 2. Question & Answer sessions at Suryan FM, Madurai. 3. Article in various daily News papers. 4. Healthy food competition conducted among college students in bringing nutrition and health.

Future Plans 1. To conduct a live telecast programme in satellite TV. 2. Obesity Clinic Marketing for teachers & parents. 3. Conduct a CME among practitioners in Southern Tamilnadu. 4. Provide awareness about our obesity clinic to all our stakeholders - well wishers and suppliers, Bankers, TPAs, Corporates and Donors. 5. Planning to conduct obesity camps and awareness programmes to Madittsia & Rotary club members, service organizations, walkers club, lions club members, ladies colleges, and pensioner’s clubs etc. 43


World class care within everybody's reach

Obstetrics and Gynaecology

Obstetrics HIGH RISK OBSTETRIC CARE with good maternal and fetal outcome at affordable cost is the hall mark of the Obstetrics department. Our hospital is the first in South Tamil Nadu to start a dedicated Obstetric critical care - High dependency Unit (HDU). We handle a wide spectrum of critically ill pregnant women with various medical and surgical problems. The support of other allied departments and excellent neonatal care helps these sick women to have a good outcome. The FETAL MEDICINE UNIT of hospital was started this year to provide facilities for obstetric scans, fetal Doppler and Diagnostic Invasive procedures like chorion villous sampling, amniocentesis and fetal blood sampling. We performed intra uterine transfusion successfully twice for a patient with hydrops for the first time in South Tamilnadu. Dr. Asha visiting Professor , Maternal and Fetal Medicine Division, Department of Obstetrics and Gynaecology, University of IOWA inspired us to start a fetal medicine department at our hospital. Dr. S. Padma, Senior Consultant and HOD visited the University of IOWA Hospital in May 2009 for training to set up the fetal medicine unit here. We proposed to hold fortnightly antenatal classes shortly for the benefit of expectant mothers and their families.

44


World class care within everybody's reach Special Service

Ovarian cystectomy Myomectomy.

Pre pregnancy counselling.

Adhesiolysis.

Recurrent pregnancy loss clinic . NST and CTG facilities.

Surgical management of ectopic pregnancies.

Labour Analgesia.

Sterilization etc.

Hysteroscopic procedures

Gynaecology We care for women from adolescence to menopause and also beyond . Each individual patient is counselled for her problems and various treatment options are available. Finally we help them to choose an appropriate tailor made treatment, taking into account for her special needs and medical conditions. Minimal access surgeries – (Laparoscopic and Hysteroscopic procedures) are performed on majority of patients towards better patient comfort.

Services Available are Menorrhagia Clinic . Evaluation and Management of primary and secondary Amenorrhoea.

Cancer screening and prevention...

HPV testing and vaccination. -diagnostic

Septal resection. Endometrial ablation etc. Gynaec Oncology – Radical surgeries Wertheim's Hysterectomy. Staging Laparotomy for endometrial and ovarian malignancies etc. We have two dedicated well equipped operation theatres with state of the art facilities at par with international standards and post operative ward with continuous monitoring facilities to ensure excellent care.

Family planning Counselling is done for couples to adopt appropriate method of contraception followed by delivery or abortion. Our hospital is a Government recognized centre for performing tubectomies.

Pap smears.

Colposcopy therapeutic.

Diagnostic Polypectomy.

and

Academics

Abdominal and vaginal hysterectomies.

MMHRC is recognized for DNB training in Obstetrics and Gynaecology since 2000. We under take 2 primary (MBBS) and 2 post DGO candidates every academic year for training

Site specific repair of pelvic prolapse including mesh repair.

Conferences / Workshops attended

Gynaecological

Surgeries...

Post hysterectomy vault prolapse. MTP and sterilization.

organ

Dr. S. Padma AGOICON 2009, 18th Annual conference by Association of Gynaecological Oncologists of India, Ludhiana, Punjab – Faculty

Recanalisation. Laparoscopic procedures.

Yuva Fogsi ( South Zone ) -2009, Madurai Faculty

Total Laparoscocpic Hysterectomy.

45


World class care within everybody's reach

Our Performance Operative Procedures : (Major )

762

Polypectomy

3

Lap. Hysterectomy

103

Suturing of Perineal Laceration

1

Abdominal Hysterectomy

93

Re-suturing of Skin

6

Staging Laparotomy

12

Pyometra Drainage

3

Laparotomy And Proceed

15

Suction Evacuation

14

Wertheim's Hysterectomy

9

Delayed Primary Suturing Of Skin

Vaginal Hysterectomy

24

Aminocentesis

2

D.lap. And Proceed

85

Fentons Procedure

1

Lap. Cholecystectomy

2

Vaginal Exploration

1

Cystocele Repair With Mesh

1

EUA

1

Cervical Encirclage

8

Vaginal Mass excision

2

Hystero Lap And Proceed

11

Vaginal Wall cyst excision

1

Hysteroscopy And Proceed

24

Vulval Biopsy

1

Vaginal Wall Repair

1

Cervical Biopsy

2

Primary Cyto Reduction

1

I and D

1

CPT Repair

3

Obstetric Hysterectomy

2

Delivery

569

LSCS

324

Excision Of Vaginal Septum

46

And Drainage Of Hematocolpus

1

Normal Delivery

221

Lap. Myomectomy

1

Forceps

24

Open Myomectomy

2

LSCS

324

Family Planning

214

Hysterotomy

4

MTP With TAT

19

Lap. Tubal Ligation

31

Lap Sterilization

31

Splenectomy

1

PS

135

Incisional Hernia repair

1

MTP

29

Appendicectomy

1

Minor

96

Fractional Curettage

38

USG Guided D&C

18

In Patients

:

1469

Out Patients

:

10511


World class care within everybody's reach

Ophthalmology The department is an advanced tertiary care centre, providing sub-specialty level care to the patients. The latest evolution of cataract surgery, namely reflective cataract surgery is our forte. This philosophy aims at providing the patients with the vision to exactly suit their needs with great accuracy. This service is further complemented by multifocal intra ocular lenses (Multifocal IOLs) and Toric IOLs. The department is among the selected centres in the state capable of offering such service. In the year under review, we had introduced MICS (Micro Incision Cataract Surgery), justifiably hailed as the cutting edge cataract surgery of today. The usual complements of services like cornea, glaucoma (field analyzer), squint, medical retina (angiography and retinal laser) are available to meet the needs of our patients. We offer emergency eye care round the clock making an unique feature in the city. Our focus on community service remains focused and free eye camps are being conducted to poor and needy persons in remote areas of the surrounding seven districts. These patients are provided free cataract surgery with IOL implantation along with other related care during the period. The department is gearing towards meeting the further challenge of diabetic eye disease of epidemic proportions. Emphasis on screening diabetic patients, delivering counselling and treatment are the important components of this endeavour. In the past year, we have collaborated with Kalasilingam University, Krishnan koil for conducting basic research into the mechanisms of diabetic retinopathy resulting in the presentations and publications in peer reviewed international journals.

Our Performance Out Patients (Free) In Patients (Free) Out Patients (Paid) In Patients (Paid) Procedures Paid Free

: : : :

1680 2830 743 233

: :

361 858 47


World class care within everybody's reach

Orthopaedics and Traumatology

Centre for Joint Replacement, Arthroscopic and Spinal Surgery This is one of the tertiary referral centres for the management of musculoskeletal disorders, joint replacements, trauma, arthroscopic and spine surgeries. The National Board of Examinations, New Delhi, has recognized us for Post-Graduate training for the Diplomate National Board degree in Orthopaedics. The academic course starts in the month of June and we admit two candidates every year. We are awaiting approval from the National Board to admit 4 candidates per year. We are backed with the state-of-the-art facilities at par with international standards in the management of trauma and experienced to manage mass casuality cases and disaster management. Management of polytraumatised victims is a regular feature and multidisciplinary interaction under one roof is a boon for successful management of these patients. 24 hours Accident and Emergency services are readily available to provide best possible treatment for patients. Teamwork has been a hallmark of functioning in this institution and availability of many teams has led to successful, simultaneous management of accident victims, thereby reducing the waiting time for surgery, earlier rehabilitation and also reduced hospital stay. High velocity trauma results in, multiply injured patients with multisystem involvement as well as involvement of the skeletal system. We follow the latest modalities of fracture fixation which includes the AO principles and in most of the patients with long bone fractures, the patient is ambulated on the 2nd post-operative day. Intramedullary interlocking nailing has reduced the morbidity of patient and help the patient get back to his work at the earliest. Locking compression plating has been a very good option in condylar fractures, periarticular fractures, fractures of the upper limb and in Osteoporotic fractures.

48


World class care within everybody's reach Apart from trauma, successful management of

Replacement Arthroplasties. As there is a need

spine disorders and backache forms the

for the patients and public to be benefited, we

mainstay in functioning of the department. The

have come out on a package system in which the

patients have approached systematically,

conventional knee replacement surgery with the

utilizing the latest modalities of treatment.

imported implant costs only Rs. 1,20,000/- while

Patients are benefited by minimally invasive

with an Indian implant, it costs Rs. 85,000/- only.

surgeries and endoscopic surgeries. Lumbar and Cervical Disc surgeries with or without stabilization, decompression and stabilization for treatment of lumbar and cervical stenosis are regular features in the department. Elderly patients commonly sustain osteoporotic vertebral compression fractures and early mobilization of these patients to prevent long term recumbency of the patient. Simple, effective way of treating these fractures by vertebroplasty has made these elderly patients come back to

Sport injuries are quite common these days as the number of people taking up sports for fitness as well as profession. Contact sports, adventure sports are also increasing. Meniscal injuries are best manged arthroscopically and arthroscopy assisted ligament reconstructions, treatment of meniscal injuries have reduced the morbidity and patients get back their sporting activites at the earliest. Arthroscopic shoulder surgeries is gaining popularity nowadays.

their normal activities. Kyphotic deformity

Health education has also been an integral part

(forward bending of the spine) is effectively

of the department activites and recently we have

corrected by kyphoplasty in indicated patients.

started pubic awareness and education

We have a comprehensive spinal injury setup

programmes about musculoskeletal disorders.

and all spinal cord injured patients are managed

We are planning to conduct more camps at

effectively along with appropriate rehabilitation

different places and also about different

measures.

disorders. We also conduct free camps, have

With the growing geriatric population, the incidence of arthritis is on the rise, which is again double folded due to rheumatoid arthritis. Arthritis is managed according to the stage, and

meetings with doctors and appraise them on recent advancements in the field of Orthopaedics .

Management of Musculoskeltal Tumours

the cause, the management varying from conservative management with health

Well qualified, experienced and dedicated

education, diet management, physiotherapy etc.

faculties are available round the clock & treat

The awareness about Total Joint Replacement

many polytramatized patients and give back

has increased in the nuclear families and elderly

lives and limbs of these unfortunate victims. The

patients would like to be independent. Total joint

faculty also gets updated with the latest

replacement has been a boon to them and as the

developments & upgrades.

research and advancements in the design of the implants have improved, today we have Total joints where patients can do all activities including sitting on the floor, sitting cross legged,

Services Available Total Joint Replacements Minimally Invasive

squatting and also kneel doing their prayers

Total Hip, Total Knee, Total shoulder,

Total

regularly. Younger patients with Avascular

elbow,

Necrosis of the femoral head and secondary

High performance arthroplasties, Metal on

arthritis are being benefited by surface

Metal, Ceramic on Ceramic.

Surface Replacement arthroplasties,

49


World class care within everybody's reach Spine Surgeries

Organized a camp at Amar Seva Sangam, Ayikudy.

Spinal injury Comprehensive Management, Comprehensive management of primary and metastatic spinal tumors, Management of Vertebral & Epidural infections, Minimally invasive spine surgery, Surgery for spinal canal stenosis & spinal instability, Scoliosis, Kyphosis

Physical Disability Assessment camp at Thirupathur. Organized a one day CME on Low Friction Joint Replacement, including live surgical demonstration by two French Surgeons.

and adult deformity correction, Revision of spinal

Inaugurated the Centre for Joint

surgeries, Disc Replacement (Cervical &

Replacement Surgery.

Lumbar), Vertebroplasty and Kyphoplasty.

Arthroscopy Diagnostic, Debridements, Meniscal repairs, ACL, PCL reconstructions.

Trauma

Organized a one day CME on Geriatric Orthopaedics.

Visits Dr. Dasaratha Rama Reddy, one of the Directors of Yashoda Hospitals, Hyderabad, visited the Department as a DNB Inspector for renewal of

Closed Interlocking Nailing –Femur and Tibia, Reconstruction Nailing, Proximal Femur Nailing,

accreditation and was highly impressed with the activities.

Distal Femur Nailing, Flexible Nailing in Children, Locking Compression plating DCS,

What's New ?

DHS, Bridge plating, Closed reduction and casting.

Compound Fractures Primary stabilization with flap covers.

Limb Reconstruction Deformity correction, Lengthening, LRS, Ilizarov

Endoscopic Spine Surgeries. Single Incision for both Anterior and Posterior spinal decompression and Stabilisation. Low friction arthroplasty. Metal on Metal Joint Replacement.

technique.

Ceramic on Ceramic Joint Replacement.

Condolence

Single Stage Bilateral Total Knee Replacement.

The department deeply mourns the demise of Dr. Prof. M. Muthusamy, on 5.9.2009. He served as a Senior consultant in the Department for more than 12 years, and CME on his memory was conducted.

Meetings Conducted Dr. Amarjit Singh Chahal, Director General of Indian Spinal Injuries Centre, Gavera talked on Past, Present and Future of Spine Surgery. 50


World class care within everybody's reach

Future Plans

Conferences and Workshops attended

Dr. Sathyanarayana. 1. Stem Cell therapy in treatment of various Orthopaedic conditions including the spinal cord injuries. 2. Deformity correction using the Hexapod apparatus.

V, Senior Consultant

& Head of the Department 1.

Lecture and presentation of 2 papers and 2 posters at the Annual Conference of Karnataka Orthopaedic Association.

2.

Talk on recent trends in Joint Replacement Surgery at Kulalumpur, Malaysia.

3.

Orthopaedic Update Series at Cairo, Egypt.

4.

Deformity Correction Course using Hexapod at Goa.

5.

Delta Revision Hip and Knee course Hyderabad.

6.

Annual Conference of the Association of Spine Surgeons of India at Chennai.

3. Arthroscopy of smaller joints.

Membership with Professional Bodies

at

1.

Indian Medical Association.

2.

Karnataka Orthopaedic Association.

3.

Tamilnadu Orthopaedic Association.

4.

Indian Orthopaedic Association.

5.

Asian Association of Dynamic Osteosynthesis.

7.

Annual Conference of Indian Society o f Hip and Knee Surgeons at Delhi.

6.

American Academy of Orthopaedic Surgeons.

8.

7.

Association of Spine Surgeons of India.

Annual Conference of Indian Orthopaedic Association at Bhubaneshwar.

9.

Caderveric Workshop Course on Low Friction Arthroplasty at Bangkok.

8.

Arthroplasty Association of India.

9.

Indian Society of Hip and Knee Surgeons.

Dr. Balasubramanian,

Senior Consultant

& Chief Spine Surgeon

10.

National Association of Interlocking Surgeons(Founder Member).

1.

11.

Orthopaedic Association of South Indian States (Founder Member).

Association of Spine Surgeons of India Conference, Chennai- Jan 2009.

2.

Tamilnadu Orthopaedic Association Annual Conference, Coimbatore.

3.

Ganga Operative Spine Course, Coimbatore.

4.

Deformity correction by Ilizarov Hexapod apparatus, Goa.

5.

AO Spine Global Interactive advanced course, Kualalumpur, Malaysia.

12.

AO Spine.

13.

SICOT.

51


World class care within everybody's reach 6.

Instructor course of the Indian Trauma and Critical Care Society.

Delivered a talk on, Osteoporosis-prevention Medical Management strategies.

1.

Presented a paper in the Annual C o n f e r e n c e o f Ta m i l n a d u Orthopaedic Association at Coimbatore.

2.

Pr e s e n t e d 4 p a p e r s Orthopaedic Society.

and

Common causes of foot painDiagnosis and treatment at Private Medical Practitioners Association at Rajapalayam, Aug 2009. Management of Polytrauma victims. Low back pain management at BHEL, Trichy. Management of Spinal Injuries at a CME for Physiotherapists at DMH, Madurai.

Membership

Our Performance Total Number of Surgeries

:

2006

No.of day care procedures

:

772

Number of Polytraumatized patients

:

456

Number of Joint replacements

:

216

Number of Spinal surgeries

:

320

Number of Arthroscopic surgeries

:

242

2.

AO Spine- Asia Pacific.

3.

Association of Spine Surgeons of India.

4.

Indian Trauma Association.

5.

Tamilnadu Orthopaedic Association.

6.

Delhi Orthopaedic Association.

In Patients

7.

Madurai Orthopaedic Society.

Out Patients

Presented a paper and poster at the Annual Conference of Indian Orthopaedic Association at Bhuvaneshwar.

2.

Presented a paper at the Annual Conference of Orthopaedic Association of South Indian States

3.

Presented three papers at the Madurai Orthopaedic Society.

Madurai

1. Presented a poster on DISH at the Annual Conference of Tamilnadu Orthopaedic Society at Coimbatore.

Indian Orthopaedic Association.

1.

at

Dr. Ajith Kumar, DNB Resident

1.

Dr. Anchith Uppal, PG.

52

Dr. Selvakumaran, PG.

:

1827 : 12239


World class care within everybody's reach

Otorhinolaryngology ( ENT )

The department of otorhinolaryngology is progressing well with the introduction of Co2 laser. The following surgeries can be done with the help of Co2 laser. 1) Laser Tonsillectomy. 2) All laser Laryngeal surgeries including benign & malignant Lesions. 3) Laser Uvulopalato pharyngoplasty. 4) Laser stapedectomy. 5) Laser turbinoplasty etc.

53


World class care within everybody's reach

Our Performance EAR

: 113 Cases

Tracheostomy

-

21

6.

Sub mandibular Gland Excision

-

1

1.

Mastoidectomy

-

93

7.

Thyro Glossal Cyst Excision

-

1

2.

Stapedectomy

-

9

8.

Tongue Tie Release

-

4

3.

Intra tympanic GM instillation

-

2

9.

Otoscopy & FB removal

-

3

4.

Ear lobe repair

-

2

10. Tongue Biopsy

-

5

5.

Ear Canal Granulation Excision

-

4

11. Lymph node biopsy

-

1

6.

FB ear removal

-

3

12. RTA – Wound Suturing

-

9

7.

Auricular Cyst Excision

-

2

13. Parotidectomy

-

1

Nose

: 109 Cases

Others

1.

FESS

-

22

1.

DNE

:

718

2.

Endoscopic Polypectomy

-

23

2

VIDEO LARYNGOSCOPY

:

79

3.

Endoscopic DCR

-

3

3.

PSG

:

33

4.

Endoscopic Biopsy

-

13

4.

MISCELLANEOUS

:

110

5.

Rhinoplasty

-

3

6.

Osteomyelitis maxilla – Debridement

-

2

7.

DNE & Cautery

-

21

Audiogram

:

679

8.

Nasal Bone Reduction

-

5

BERA

:

42

9.

Young’s Operation

-

1

Speech Language Therapy

:

373

10. Maxillectomy

-

2

Hearing Aids Sold

:

45

11. FB Nose Removal

-

1

12. Cald Well LUC

-

1

13. Benign Tumors of nose – Endoscopic Excision 14. Endoscopic Pituitary Surgeries

Laryngology & Head Neck

54

5.

Audiology Statistics

Laser Surgeries

: 13

1.

Tonsillectomy

-

2

-

7

2.

Laryngeal Surgeries

-

4

-

5

3.

Laser Turbinoplasty

-

7

: 131 Cases

1.

Tonsillectomy & Adenoidectomy

-

36

2.

DL Scopy & Biopsy

-

25

3.

Microlaryngeal Surgery

-

14

In Patients

4.

Neck Abscess I & D

-

10

Out Patients

:

326 : 4850


World class care within everybody's reach

Paediatric Oncology

The division of Paediatric Haematology-Oncology began its service on January 6th, 2010, and thus the following report includes our activities for the past three months and some information about our goals for the future. Infrastructure: Our inpatient division consists of a 6-bed paediatric oncology unit located on the first floor of the main building. This unit was recently upgraded with air-conditioning and air-purifying units. This improves the standard of care for children with cancer, undergoing chemotherapy who are at risk for invasive fungal infections such as aspergillosis---especially in times of construction work in the hospital campus. Young children who need painful procedures like bone marrow aspirate and biopsy or intrathecal chemotherapy undergo these procedures under short intravenous anaesthesia in the fourth floor operation theatre. Some older children who are matured enough to cooperate, undergo these procedures without sedation in the out patient department, thus saving money and time. Patient accrual: We have received so far 42 paediatric cancer patients, of which 19 of them are newly diagnosed, and the remaining 23 were cases already being treated in the medical oncology division, and transferred to our care. Of these 42 patients, the most common diagnoses are acute lymphoblastic leukemia and Hodgkin's disease. Other diagnoses include neuroblastoma, germ cell tumor, ependymoma, and Ewing sarcoma; and some rare tumors such as squamous cell carcinoma, aggressive 55


World class care within everybody's reach

fibromatosis, nasopharyngeal carcinoma,

New York, and has Board certification by the

lymphoepitheloma like carcinoma of the thymus,

American Board of Paediatrics. We have a team of

and malignant peripheral nerve sheath tumor.

nurses dedicated to paediatric oncology, and they

Our average inpatient census is about (with a

are rapidly gaining the needed experience in the

range of 4 to 8), including patients in other units

field. Their education includes a weekly

because of preference for private rooms. In terms

conference with the chief.

of the number of visits, we had 430 patient visits so

Team work: We have enjoyed unprecedented

far including the inpatient days.

support and cooperation from all other

A commitment to treat all children: Early, we

departments

made a commitment to the community that we

Anaesthesiology, Radiation Oncology, Surgical

treat all children with cancer who come to our

Oncology, Gastrointestinal Surgery, Urology,

hospital irrespective of their financial status. With

Neurology, Physical Therapy, Emergency

the help of our Camila Children's Cancer Fund, we

Medicine, IRCU and the various divisions of

have been able to help children from poor families

Laboratory Services (Heamatology, Chemistry,

by paying for expensive drugs (chemotherapeutic

Biochemistry etc) and such team work will be the

drugs, antibiotics) and for some expensive

key to the success of this service to children with

diagnostic tests.

cancer.

Public relations: Our R& D department is working

In the near future: We will have a new paediatric

hard to make the public aware of our services to

oncology unit at MMHRC, spread over three floors

children with cancer through articles in

(the 5th,6th and 7th floor) of the new wing-

newspapers. And they are working to improve the

consisting of 24 in patient beds (including 8 private

awareness of the public about contributions of

rooms), an outpatient division with a

Camila Children's Cancer Fund and thus to attract

chemotherapy infusion area to treat about 40

more donations to the fund - to help us fulfill our

patients a day; and a 10 bed paediatric ICU-for

commitment. Recently, they hosted an event in

oncology and general paediatric patients. It is

which film artiste Miss. Sneha participated.

expected to be fully open in the next three to four

The marketing department of MMHRC has

months.

arranged frequent IMA conferences in various

Long-term goals: As we reach our goals for the

cities. Topics on early diagnosis, curability as well

first year -accruing a large number of patients we

as recent advances in childhood cancer were

plan to establish a haematopoietic stem cell

discussed. The responses have been mostly

transplant (bone marrow transplant) service for

positive, and we are seeing more and more

children at MMHRC during the second or third

patients.

year of our service. Our next goal would be to

Staff : In addition to the chief of the division of

establish a training program in paediatric

paediatric haematology-oncology, we have

haematology oncology during the 3rd or 4th year

added a junior consultant Dr. R. Priya, to our

of our service.

division. Dr. R. Priya did her paediatric postgraduate training in Maimonides Medical Centre,

56

including

R a d i o l o g y,


World class care within everybody's reach

Paediatrics and Neonatology

As a referral centre, we are providing excellent services to many complicated and referred cases. Through our dedicated service, we have acquired very good reputation for diagnosing and treating all types of paediatric cases. The general paediatrics consists of a separate emergency cum procedure room in addition to the general ward which is equipped with critical care resuscitation trolley, suction apparatus, centralized oxygen supply, intubation sets, emergency drugs, nebulizers, cardiac monitors, pulse oximeters, infusion pumps etc. Our Neonatal Intensive Care Unit (NICU) is equipped with warmer and air conditioner in order to maintain a thermo neutral environment. The NICU is equipped with mechanical ventilators (high frequency mode), neonatal trolleys, double sided photo therapy units, incubators, open care warmer system with radiant warmers, centralized oxygen supply, pulse oximeters, apnea monitors, ET Co2 monitors, NIBP monitors, cardiac monitors, CPAP and sufficient infusion pumps. We are having transport incubators which serve to transport the babies from other hospitals where they are born. Our neonatal Intensive Care Unit is well known for its excellent service to preterm and sick new born babies. To avoid cross infections, the unit is divided into septic and aseptic units. Much importance is given to aseptic techniques while dealing with neonates. Since the number of newborn admissions are increasing day by day, we have purchased additional ventilators and warmers.

57


World class care within everybody's reach The department has started DNB course having two primary candidates and one secondary candidate. In addition to routine activities, academic activities are also being carried on. Bedside case discussions, grand rounds, journal club discussions, internal assessment exams are the various academic activities routinely done. Various research activities are carried out in the department. Our PGs are doing research about clinical profile of persistent pulmonary hypertension on newborns, incidence of nosocomial pneumonia among ventilated newborns and clinical profile of viral haemorrhagic fever. We have also revived many number of viral haemorrhagic fever cases. All of them were effectively managed by our team and acquired good reputation from the public. Being the only hospital in Madurai providing surfactant therapy and ventilatory care for premature babies and RDS has placed the initial steps in providing tertiary care for the very sick babies and extreme premature babies. The outcome of premature babies treated with surfactant therapy, parenteral nutrition and hyperbilirubinemia treated by exchange transfusion are well comparable with any other well-equipped tertiary care centres in our country. Ventilator care and surfactant therapy provided here has improved the survival rate of preterm babies with respiratory problems. With the help of Blood bank and free availability of blood component therapy, complicated and rare bleeding disorders, platelet disorders, thalassemia, septicemia and haemophilia are managed successfully. Exchange transfusions has saved many newborn with RH haemolytic disease. Super specialities in Surgery, Urology and Plastic Surgery have helped us to provide best treatment

58

for children with acute surgical and urological problems and also correction for congenital anomalies. Several interesting, complicated cases and rare syndromes have been diagnosed and treated in our department successfully. As per our aim to serve poor people, we are also conducting free paediatric health camps on every Saturdays to the lower socio economic children. Laboratory investigations are done at concessional rates during these camp days. By this initiative, economically deprived people are also getting treatment from our hospital. It also provides free immunization (BCG &OPV) on all working days.


World class care within everybody's reach

Our Performance Respiratory System Bronchopneumonia LRI ALT B Bronchiolitis Pneumonic consolidation Status Asthmaticus Interstitial lung disease Lung Abscess Empyema thorax Hyperactive air way disease Aspiration pneumonitis Disseminated tuberculosis

: : : : : : : : : : : :

136 51 6 9 10 10 4 5 10 9 3 3

: : : :

21 5 5 4

: : : : : : : : : : : : : : : : : : :

102 36 15 11 10 6 2 6 3 2 8 4 1 3 5 3 5 6 3

: : : : : : : : : :

84 40 27 14 12 18 5 2 4 1

Cardiovascular System Congenital Heart Disease Rheumatic heart disease Dilated cardiomyopathy PDA closure Gastro Intestinal System AGE Hepatitis Intussusception Acute Abdomen Gastritis Haematemesis Neonatal cholestasis Multiple liver abscess Chronic diarrhoea Persistent vomiting with volvulus Acute Appendicitis Extra – hepatic Biliary atresia Wilson disease Biliary Atresia Perforated appendicular abscess Malrotation of small bowel Abdominal tuberculosis Hepatosplenomegaly Acute Pancreatitis Central Nervous System Acute CNS Infection Atypical febrile seizure Febrile seizure Encephalopathy with seizure Meningo encephalitis Seizure disorder Guillein Barre syndrome Stroke Cerebral palsy Neurocysticercosis

Headache for evaluation : Neuro degenerative disorde : Developmental delay with seizure disorder : Status epilepticus : Benign Intracranial Hypertension : Cerebral abscess : Hydrocephalus :

6 1 5 1 1 4 4

Renal Disorder Nephrotic Syndrome Barrtter syndrome Congenital Adrenal Hyperplasia Focal segmental glomerulo sclerosis RTA with convulsions

: : : : :

6 4 3 1 4

: : : : : : : : : : : : : :

9 5 4 2 3 3 2 1 4 2 2 2 1 2

: : : : : :

2 2 1 7 31 4

: : : : : : : : : : : : :

88 74 31 14 29 10 58 8 12 3 4 36 11

Haematology Idiopathic thrombocytopenic purpura Anaemia with Thrombocytopenia ALL Factor VIII deficiency Factor VII deficiency Haemophillia Thalassemia Auto Immune hemolytic anemia Epistaxis Bicytopenia for evaluation Factor XIII deficiency Thrombasthenia Myelodysplastic disorder AML Dermatology Chicken pox with secondary infection Erythema multiforme Herpes Labialis TAEN Insect bite allergy Staphylococcal scalded skin syndrome General Paediatrics Viral Haemorrhagic Fever Pyrexia of unknown origin Enteric fever Scalds Sepsis Foreign body Aspiration Acute febrile illness Acute exanthematous fever UTI fever Near drowning Dengue Fever with shock Haematuria Acute otitis media

59


World class care within everybody's reach Left gluteal absess Haematoma - Right gluteal region Tuberculous Adenitis Pre – auricular abscess Gangrene of middle finger Multiple abscess Umbilical abscess Tongue Injury Chronic Tonsillitis Multiple contusion Cellulitis left thigh Vasculitis Cardiogenic shock Inguinal hernia Necrotising Fasciitis Acrosyndactyl Right hand Reactive polyarthritis Cervical lymphadenitis Poisoning Accidental poisoning ( Lice killer) Hydrocarbon Ingestion Organophosphorus Poisoning Snake bite Lysol Poisoning Organochloride poisoning Datura poisoning

: : : : : : : : : : : : : : : : : : : : : : : : :

7 5 3 3 1 1 1

Road Traffic Accidents & Trauma Perineal injury : RTA : Head Injury :

21 3 3

Miscellaneous Haemangioma of lip Haemangioma scalp Acute myeloid leukemia Neuroblastoma

2 1 2 2

: : : :

CVS CHD Persistent pulmonary Hypertension of newborn Tetralogy of Fallot

Gastro Intestinal System Hypertrophic pyloric stenosis Perforation peritonitis Necrotising Enterocolitis Megacolon Bleeding Neonate Low-Ano-rectal anamoly Midgut volvulus Malrotation of gut Neonatal Hepatitis Neonatal cholestasis

: : : : : : : : : :

5 6 6 2 4 4 1 4 4 2

CNS Neonatal seizure Hypoxic Ischemic Encephalopathy IVH Meningo myelocele Acute CNS Infection Cerebral abscess

: : : : : :

60 25 5 2 1 2

Neonatal Jaundice Pathological - Jaundice RH Incompatibility

: :

67 14

:

11

: :

4 3

: : : : :

1 2 2 1 1

: : : : : :

41 15 7 3 2 1

: : :

1 1 1

: :

1 1

Anomaly Cleft lip and cleft palate Congenital tracheo-oesophageal fistula Congenital diaphragmatic hernia Congenital cystic adenomatoid malformation Hydrops foetalis Developmental dysplasia of hip Multicystic dysplastic right kidney Congenital cystic hygroma

:

18

Miscellaneous Septicemia IUGR Vomiting for evaluation Neonatal Thrombocytopenia Large baby Epidermolysis Bullosa Haematoma testis with sub conjunctival haemorrhage Neonatal chicken pox Cellulitis Neonatal Erythematous pustular skin Lesions Subcutaneous fat necrosis

: :

14 1

In Patients

:

1371

Out Patients

:

8360

Neonatology Respiratory System Birth Asphyxia : Preterm with RDS : MAS : Newborn with Respiratory Distress : Pneumonitis : Lower Respiratory tract Infection :

60

7 3 1 1 1 1 3 3 3 1 2 2 1 4 1 1 1 4

89 62 30 29 6 1


World class care within everybody's reach

Pharmacy

Our hospital has an onsite pharmacy department, which is the key purpose of ensuring receipt of the right medicines at right time by an efficient and economical system. We have adopted and applied the best pharmaceutical expertise to help in maximizing drug efficacy and minimize drug toxicity.

The core features Adhering to the guidelines as per the Drug and Cosmetics Act 1948 for Pharmacy Management. Deliverance of standard medicines to the customers. 24 hours round the clock quality patient care services. Well trained quality pharmacists. Controlled temperature helps in maintaining the quality of medicines and efficiency. The entire system is computerized.

We also‌ Provide maximum patient care. Ensure quality patient services. Educate the patients. Facilitate adverse drug monitoring. 61


World class care within everybody's reach

A boon to mankind in alleviating pain and leading a healthy life.

Physical Medicine and Rehabilitation

The department of physical medicine & rehabilitation work with the philosophy of...

The patient comes first under any circumstance. Physiotherapy department is one of the largest equipped units with latest equipments, working in all sub specialities. Qualified and highly experienced team of physiotherapists providing OPD services (Direct and referral) and IPD services ( in wards and intensive care units) with treatment procedures with international standards, to offer a multifaceted approach for patient rehabilitation. Physiotherapists offer wide range of therapies after examination, tailored to suit every individual needs. We aim to restore functioning of the body, reduce impact of dysfunction, disability & pain of the body from trauma & disease as to improve mobility, health and reduce risk of injuries.

Therapies include Manual Therapy - Stretching, manual resistance training, joint mobilization and manipulation, manual lymphatic drainage (Post lymphedema), chest physiotherapy. Electro Therapy Techniques - Short-wave-diathermy,. Ultra-Sound therapy [1mhz,3mhz], pelvic & cervical traction[continuous & intermittent], Interferential therapy, Wax-Bath, Electrical muscle stimulator, T.E.N.S, Slim-up,Vacuum therapy.

62


World class care within everybody's reach Exercises Posture training, muscle strengthening, cardio vascular training and stretching.

Other services Advice orthosis and prosthesis (post amputation) offering information regarding equipment aids (wheel chairs, walking aids), taping and splintings.

Facilities available Electrotherapy - SWD/IFT/Ultrasonic/ MS S t i m u l a t o r, T. E . N. S, Pa r a f f i n w a x b a t h , Cryotherapy Diagnostic - SD curve/MS testing/ADL assessment Mechanical - Traction Cervical/ Lumbar/ Pelvic/ C.P.M. for lower extremity. Tiltable, rowing, treadmill.

For Neurological Disorders - Proper positioning of the limbs (Anti synergic patterns) general mobility & strengthening exercises, PNF, Bobath. ICU post surgical care - Chest physio & general mobility exercises, Incentive Spiro meter ex, Bronchial hygiene, Proper positioning of the operative side/part, Ambulation. HAEMOPHILIA FEDERATION OF INDIA Madurai chapter gives physiotherapy care and advice through our department.

Academic activities In Department Various physiotherapy colleges under affiliation to Tamil Nadu Dr MGR Medical University have tied-up with our hospital to get C.R.R.I for BPT students

National Level Conferences

Manual Mobilization Therapies - Mobilization couch with specific features for mobilization.

Our department organized PHYSIOCON ‘09, National level conference on 20th Sep 2009 on the theme: Physiotherapy in Diabetes. More than 320 delegates attended all over India.

Exercise Therapy - Active/ Assisted/ Passive/ Resisted/ Graded resisted exercises, PNF t e c h n i q u e s , s u s p e n s i o n t h e r a p y, Theraband/tube exercises.

The core idea at the department of physical medicine & rehabilitation is to ensure that rehabilitation is done in a short period so as to make life normal.

Chest Physiotherapy - Assessment of pulmonary functions, therapeutic functions, postural Drainage, Therapeutic, Interventional physiotherapeutic procedures, Nebulization Breathing exercises, Incentive Spirometer, Humidification, home care and follow ups. Gynae/Obstetric - Antenatal & postnatal Ex., postural correction & awareness, Fitness Assessment & Improvement etc.

Our Performance In Patients

:

30669

Out Patients

:

4236

Post Operative Cardiac Surgeries - Following the cardiac surgeries, Pre & Post operative physiotherapeutic exercise for patients including - breathing exercises, chest manoeuvers, humidification, nebulization, Incentive spirometers, Limb Physiotherapy, cardiac rehabphase I –IV

63


World class care within everybody's reach

Plastic Surgery / The Regional Smile Train Centre

Plastic Surgery is one surgical specialities which deals with conditions from head to toe. It may be hair transplantation in the scalp, cleft correction or facio maxillary injuries in the face, neck contractures in neck, gynaecomastia or breast augmentation, abdominoplasty in abdomen, hypospadias correction in the genitals, syndactyly or hand injuries in upper limb, sacral pressure sores in back or lower limb bone exposed raw areas. We have been doing all types of plastic surgeries in our department.

Cosmetic Surgery With the advent of more and more awareness about self appearance and beauty, nowadays cosmetic surgery has become a significant field of plastic surgery. We have been doing all types of cosmetic surgeries like hair Transplantation, Blepheroplasty, Face lifts, Rhinoplasty, Breast augmentation, G y n a e c o m a s t i c c o r r e c t i o n , L i p o s u c t i o n , A b d o m i n o p l a s t y a n d b o d y c o n t o u r i n g.

Reconstructive Surgery Post cancer surgery reconstruction of head and neck or breast, pressure sore coverage, lymphedema surgery, chest wall and abdominal wall reconstruction or reconstruction of lower limb defects are part of this reconstructive surgeries.

Craniofacial and Cleft Surgery With the help of Smile Train, USA we are one of the leading centres doing cleft surgeries in South Asia. Facial cleft surgeries, cleft lip and palate surgeries, pharyngoplasty and cleft orthognathic surgeries are done in our Smile Train regional centre. We have the state-of-the-art fibre optic nasopharyngoscope and Dr. Speech software to assess the velopharyngeal incompetence. So far, we have completed more than 5000 cleft lip / palate surgeries free of cost. 64


World class care within everybody's reach Maxillo facial Surgery All types of facial bone fractures and mandibular fractures are managed by open reduction and internal fixation using mini plates and screws. Temporo mandibular joint ankylosis is managed by inter position arthroplasty.

Congenital anomalies Microtia, hypospadias, congenital anomalies of hand and toes, constriction ring syndrome, and branchial cleft defects are some of the congenital anomalies which are managed in our department.

Head, Neck and Face surgeries

Rhinoplasty

-

02

Haemangiomas, hairy nevus and facial reanimation surgeries are done.

Haemangioma

-

05

Burn injury

-

15

Burns

Gynaecomastia

-

03

Liposuction

-

05

Fat filling

-

01

Thumb reconstruction

-

01

Pressure sore Reconstruction

-

03

Reconstruction of lower limb defects -

33

Chronic ulcer reconstruction

-

17

Ear reconstruction

-

01

Contracture Release

-

06

Breast Augmentation

-

01

Vaginoplasty

-

01

Plexiform neurofibroma

-

01

All types of thermal, electric and chemical burns are managed in our department. Both acute burns and post burns sequelae are managed. Our department has dedicated operation theatre for plastic surgery cases with 2 tables functioning at a time. The operation theatre is equipped with state-of-the-art Boyles apparatus and multi parameter monitor with a fully equipped recovery room.

Our Performance Unilateral Lip

-

267

Hair Transplant

-

01

Bilateral Lip

-

45

Post Burn control release

-

02

Palatoplasty

-

369

BK Amputation

-

02

Facial cleft

-

02

AV malformation

-

01

Revision Lip

-

12

Flap Cover

-

08

Revision Palatoplasty

-

23

Skin Grafting

-

20

Fistula Repair

-

25

Excision

-

18

Pharyngeal Flap

-

10

Primary Closure

-

22

2 nose correction

-

05

Alveolar bone graft

-

12

Scar revision

-

Traumatic lesion in head & neck

-

Tongue tie release Lobuloplasty

In Patients (Free)

:

720

20

Out Patients (Free)

:

2404

-

04

In Patients (Paid)

:

310

-

03

Out Patients (Paid)

:

950

65


World class care within everybody's reach

Psychiatry and Counselling

Our Performance Total Cases

: 3758

Total Admission : 133

Mental Health is a paramount importance for personal well-being, family relationships and individual's ability to contribute to the society . The prime goal is to relieve an individual from his mental illness is to enhance the quality of life of an individual and to foster the family's harmony. Provision of Mental health services based on ethical and evidence based scientific standards combined with empathetic cost- effective quality care has been continued to be the guiding principle of our department. Emphasis is laid upon complementing most modern psychopharmacological interventions with pragmatic principles of psychotherapeutic interventions such as cognitive behaviour therapy; crisis intervention counselling, Marital counselling and family focused psycho education models. Holistic provision of health by therapeutic collaboration with eminent faculties from Andrology, Urology, Nephrology, Surgery & Medical Gastroenterology, Cardiology, CTVS, N e u r o l o g y, N e u r o s u r g e r y, Pa e d i a t r i c s , Anaesthesiology & IRCU, Orthopaedics, Obstetrics & Gynaecology enhances the delivery to liaison the psychiatry services. 66

Unique therapeutic interventions such as somatic reattribution model of counselling for medically unexplained physical symptoms, sleep hygiene enhancement for sleep related diseases and psychotherapeutic techniques which are modified and adapted for our sociocultural milieu are provided along with treatment for newer disorders such as internet pornography & social networking addiction.

Speciality Services 1. De addiction psychiatry – Smoking cessation clinic, Inpatient de addiction treatment for alcohol dependance, oral tobacco and IV drug abuse. 2. Child psychiatry – Management of ADHD, Childhood Depression, Parent Management training and Behaviour modification. 3. Neuro psychiatry – Management for psychiatric co morbidity of stroke, epilepsy, and Parkinson's' disease. The department of psychiatry reaffirms its faith in walking the talk of the path to perfection by improving the quality and standards of psychiatric care for populace of south Tamilnadu.


World class care within everybody's reach

Radiation Oncology

Radiation Oncology unit in our hospital deals with cancer patients who require Radiation Therapy for their cancer treatment. Almost 70% of the cancer patients would require radiation as their treatment. Patients are managed only after discussion in the tumor board which comprises of Oncologists - Surgical, Medical & Radiation and Pathologist. Most of the cancers are tackled only in a multimodal approach. The department is equipped with Linear Accelerator Equipment, Telecobalt Equipment, HDR Brachytherapy (Microselectron) Mould Room. The year 2009 – 2010 has been a remarkable year in two aspects... I. We have procured a Linear Accelerator Equipment with the provision for upgradability to three dimensional conformal Radiation Therapy (3D – CRT) and Intensity Modulated Radiation Therapy (IMRT) and Image Guided Radiation Therapy (IGRT).It has the advantages of greater penetration with less amount of undesirable side effects because of higher beam energy and sharp beam characteristics. II. Research Activities (Clinical Trials) :As a leading Research Institution, Meenakshi Mission Hospital and Research Centre is a part of many clinical trials conducted across the Globe. Research Activities are being taken up in a big way. As the days go, the number of clinical trials are also increasing steadily. There are lot of advantages with these clinical trials. The important one is the newer drugs are available for unfortunate recurrent diseases to cancer patients even before it is available in the market. These facilities were available earlier only in western countries. 67


World class care within everybody's reach Brachytherapy

Paper presented

Other facility in this department includes HDR Brachytherapy. Brachytherapy is a method of delivering radiation to tumours by placing radioactive sources either within or immediately adjacent to tumour tissue. Because the radiation source is very close to the tumour, radiation can go directly to the tumour without traveling through normal tissue. Brachytherapy can be given by low dose rate or high dose rate techniques, depending on the length of time the radioactive sources remain in place. Indications for which the Trials were being conducted :

Topic : Efficacy, Safety and Patient Acceptability of Fentanyl Pectin Nasal Spray Compared with Immediate-Release Morphine Sulphate Tablets in the treatment of breakthrough cancer pain : A Multicentre, Double-Blind, Double-Dummy, Multiple-Crossover study. M. Fallor, A. Gatti, A. Davies, E. A. Lux, K.S. Kirushnakumar, R. Galvez on behalf of the Fantanyl Pectin nasal spary study 044 investigators group.

1. Oesophageal Cancer

IIB -

Completed

2. Cancer Pain

III -

Completed

3. Breast Cancer

II -

Completed

4.

Breast Cancer

BE -

Completed

5.

Glioblastoma Multiforme

BE -

Completed

6.

Cancer Pain

II -

Completed

7.

Endometrial Carcinoma

II -

Ongoing

Edinburgh Cancer Centre - Edinburgh, UK, Azienda Policlinico Tor Vergata - Rome, Italy, The Royal Marsden NHS Foundation - Trust Surrey, UK, St. Marien – Hospital Lunen, Germany, Meenakshi Mission Hospital - Madurai, India, Unidad del Dolor /Hospital Virgen de las Nieves Granada, Spain.

8.

VTE in Cancer patients

III -

Ongoing

Lectures delivered

9.

Metastatic Breast Cancer

I/II -

Ongoing

10. Pancreas Cancer

I/II -

Ongoing

11. Head and Neck Cancer

I/II -

Ongoing

12. Prostate

II

Ongoing

-

Conferences / Workshops attended 1. Research protocol meeting for Cancer pain, Dubai, 8th & 9th May - 2009 2. Research protocol meeting for pancreas in Cancer patients, Delhi, 30th May 2009 3. Research protocol meeting for VTE in Cancer patients, Chennai, 12th June 2009. 4. Research protocol meetin g f o r Capecitabine study, Ahamedabad , 18th July 2009. 5. Research protocol meeting for VTE in Cancer patients, Singapore, 9th & 10th October 2009

68

15 th Congress of the European Cancer Organisation and 34th Congress of the European Society for Medical Oncology;20-24 September 2009; Berlin, Germany.

1. Opportunez 09 – Infections in cancer patients, August 2009, Theni medical college,Theni. 2. A R O I - T N 2 0 0 9 - I n t e r s t i t i a l Brachytherapy in Breast cancer, October 3 & 4 2009,organized by Kamakshi memorial hospital, Chennai. 3. Best of ESMO 2009 – Head and Neck Cancer, November 8, 2009, Cancer Institute , Adayar.


World class care within everybody's reach

Our Performance

Radiation Therapy Out Patient In patient

-

7551 747

Total number of patients treated with external radiation therapy

-

665

Total number of patients treated with brachytherapy

-

110

Total number of patients treated with radiation therapy under Ketamine anaesthesia

-

17

Cervix

-

146

Head and Neck

-

119

ALL

-

3

Oesophagus

-

38

Breast

-

85

Brain

-

8

Bladder

-

25

Bone

-

6

Rectum

-

28

Lung

-

29

Lymphoma

-

12

Myeloma

-

5

Prostate

-

9

Sarcoma

-

23

Stomach

-

13

Spine

-

3

Free Out Patients : 10

Eye

-

26

Total Free

: 28

Endometrium

-

15

Thyroid

-

8

Paid In Patients

: 275

Tongue

-

26

Paid Out Patients : 362

NHL

-

9

Total Paid

Renal

-

4

Vagina

-

4

Pelvis

-

2

Penis

-

2

Thigh

-

1

Liver

-

1

Galbladder

-

1

Pancreas

-

1

Others

-

12

Total

-

665

Free In Patients

: 18

: 637

69


World class care within everybody's reach

Reproductive Medicine

The birth of the baby fulfills the quest for motherhood and establishes a place in the society. Infertile couples need proper guidance and counselling for infertility and appropriate management. With the improvement in biotechnology, several hurdles in reproductive medicine have been overcome. The department of reproductive medicine aims to ensure that all the infertile couples attending our OPD gets the highest standard of care and we use all the recent updates & academic advancements in our clinical practice. We are also planning to start Embryology training programme in this year.

70


World class care within everybody's reach

Our Performance Total Number Of Deliveries

-

37

D&C

-

2

Normal Delivery

-

9

Cryo Cautery

-

2

LSCS

-

30

Diag. Hysteroscopy

-

84

3

Cervical Dilatation

-

16

Total Number Of Multiple Pregnancies -

Hysteroscopy

Pregnancy Complication PIH DM Heart Disease Anaemia

-

1 5 1 5

Polypectomy

-

3

Septate Uterus

-

7

Diag. Laparoscopy

-

38

PCOD

-

17

Total Number Of IVF & ICSI

-

31

Tubal Blockage

-

12

Uterine Anamoly

-

6

Benign Ovarian Cyst

-

17

Endometrial Cyst

-

5

Fibroid

-

4

Endometrial Curetting

-

8

Laparotomy

-

1

Myomectomy

-

5

Salphingectomy

-

2

Number Of Cases With Congenital Anomalies In The Foetus

-

5

Thyroid

-

27

Prolactin

-

2

POF

-

6

Perimenopausal

-

5

PCOD

-

32

Tubal Factor

-

17

Male Factor

-

87

Endometriosis

-

20

Fibroid

-

3

Others (unexplained)

-

235

Multiple Factors

-

39

Genital Tb

-

7

BOH

-

8

Post Recanalisation

-

6

Pelvic Factor

-

2

Total

-

495

OP Procedure IVI

-

479

HSG

-

282

Cyst Aspiration

-

4

In Patients

-

418

Out Patients

- 6263

71


World class care within everybody's reach

Surgery and Surgical Gastroenterology

The department of Surgery and Surgical Gastroenterology is a high volume centre for therapeutic endoscopy, laparoscopy and surgical gastroenterology procedures. Our work in therapeutic ERCP and laparoscopy has been appreciated at various forums both in India and abroad. We have a fully equipped endoscopy suite including endoscopic ultrasound. In 2009, we have performed Single Incision Laparoscopic Surgery (SILS) for removal of gallbladder and inflamed appendix. Conventional laparoscopic surgery is performed through 3 or 4 ports. This results in 3 or 4 incisions. In SILS a single incision is made around the umbilicus, 3 ports are placed through that and procedure is performed. In original description a large disposable port is placed in a single incision and special instruments are used to perform the surgery. The cost of the special port is Rs.27,000/-. But we have performed SILS using conventional laparoscopic instruments, thus no added cost compared to conventional laparoscopic surgery. We have performed about 30 cholecystectomies

and 15

appendicectomies using SILS. Advantages of SILS are less pain (only one incision) and better cosmesis. On the academic front, we have a post graduate course and super speciality course accredited by the Diplomate National Board in General surgery and Surgical Gastroenterology and fellowship in Minimal Access Surgery.

72


World class care within everybody's reach

Our Performance Laparoscopic Cholecystectomy

-

350

Colostomy

-

25

Laparoscopic Appendicectomy

-

130

Colostomy Closure

-

30

Diagnostic Laparoscopy

-

120

Hemicolectomy

-

25

Laparotomy Resection Anastomosis

-

100

Laparoscopic Rectopexy

-

4

Laparoscopic Mesh Hernioplasty

-

125

Radical Cholecystectomy

-

4

Open Mesh Hernioplasty

-

76

Oesophagectomy

-

15

EUA + Open Haemorrhoidectomy

-

210

Cystogastrostomy

-

106

Stapler Haemorrhoidectomy

-

25

Wound Debridement

-

180

Choledochal Cyst Excision

-

10

Amputation

-

8

Whipple’s Procedure

-

25

Excision Biopsy

-

120

PI With Frey’s

-

25

Lap.fundoplication

-

15

Splenectomy

-

24

Hepatico Jejunostomy

-

15

Total Gastrectomy

-

23

Laparoscopic Cardiomyotomy

-

8

DU Perforation Closure

-

10

Anoplasty

-

3

GI Vagotomy

-

17

CBD Exploration

-

35

Thyroidectomy

-

15

Total Colectomy

-

5

Obesity Surgery

-

6

Liver Resection

-

9

LR Shunt Anterior Resection

-

20

Anterior Resection

-

28

APER

-

8

In Patients

-

3362

Out Patients

- 14598

73


World class care within everybody's reach

Surgical Oncology

Surgery has formed the basis of successful modern cancer treatment over a century. The department of Surgical oncology is dedicated to the pursuit of excellence in patient care, research and education. We perform radical resections with curative intent on patients with breast, head and neck, gynaecology and soft tissue malignancies. Neoadjuvant chemotherapy has become a norm for all locally advanced breast cancers, prior to surgery. Recurrent and residual tumors post radiotherapy in head and neck malignancies are also resected with curative intent with minimal morbidity. Improvements in anaesthesia and intensive care allows us to operate with curative intent on patients who previously deemed too old, infirm or unfit to undergo radical surgery. In the future, we plan to add neoadjuvant radiotherapy for all locally advanced head and neck malignancies, for better local control.

Conferences and workshops attended The 4th Annual Surgical oncology workshop in Tata Memorial hospital, Mumbai. NATCON IASO – Annual conference of Indian association of Surgical oncology, Kolkata. 74


World class care within everybody's reach

Our Performance Breast Cancer Mastectomy Breast conservation surgery Lumpectomy Microdochectomy Mastectomy + SSG Gynecological Cancer Wertheim's Hysterectomy Staging laparotomy for CA Ovary Interval Cytoreduction Staging laparotomy for CA Endometrium Inguinal node dissection TAH + BSO Secondary cytoreduction Head and Neck Cancers Thyroid Parotid Composite resection Neck dissection Intra oral excision Maxilla Excision of Submandibular gland Soft tissue tumor neck DL scopy Tongue Mandibulectomy B/L ND + Composite resection Carotid body tumour excision

:

96

-

64 3 25 3 1

:

20

-

4

-

1 11

-

1

-

2 1

:

72

-

36 7 1 7 1 1

Skin , Soft tissue tumors and Others

:

37

-

11

-

1 9 1 3 4 5 1 1 1

Biopsy Tracheostomy ICD I&D Amputation Wound Debridement Secondary suturing

-

55 11 25 9 2 22 8

Total number of cases

:

368

-

231 137

Wide excision + SSG Chondrosarcoma rib wide excision Biopsy SSG Lipoma PORT insertion Wide Excision Anal fissurectomy Hemicolectomy Prostatectomy Minor Cases

Major Minor

-

1 1 4 7 4

In Patients

:

-

1

Out Patients

: 1498

-

1

-

1

250

Urological Cancers Urinary Bladder

75


World class care within everybody's reach

Tele Medicine "Meenakshi - Telecare"

With the aim of improving healthcare delivery system in the under served rural areas, the telemedicine system was introduced in collaboration with Mahasemam Trust, the sister concern of our hospital supported by Direct Relief International (DRI), USA and Indian Space Research Organization (ISRO), Bangalore. Today access to healthcare, specialist diagnosis and treatment remains a critical problem in remote areas. Telemedicine technology provides a solution that has the potential to dramatically expand and access to quality medical care with international standards.Telemedicine not only immediately enhances access to medical diagnosis and treatment, but it also helps to build and sustain nation's health care capacity through sharing of expertise. Patients will now benefit from the National and International knowledge without the need to transport specialists to the country.

76


The services... Curative Services Total Patients (Dec ‘09 to Jun ‘10) Through Tele Camps Through Tele Centres

: 4975 : 1338

The Mobile Telecare Van A mobile diagnostic van provides super speciality services and diagnostic facilities such as X-Ray, ECG, Ultra sound scan, Echo

Provides comprehensive quality healthcare services with innovative usage of telemedicine. Mobile Lab & Diagnostic Centre : A Mobile van (fitted with, X-ray machines, ECG, UltraSound and Lab facilities) offers diagnostic and laboratory services on the spot. Mobile super speciality centre : A van (Telemedicine van) with advance facilities and doctors, visits the centres for super speciality consultations.

test and other medical requirements. On an average, monthly 6-8 camps are conducted through mobile diagnostic van. Through telecardiology camps, nearly 800 patients were screened. Among the selected patients with ASD, VSD and RHD treatment was provided by the hospital.

77


World class care within everybody's reach Preventive services and health education Regular health and hygiene education by public health expert is imparted in rural areas. Training of Trainers (TOT) at the rural centres were also provided. The public health officer (picked from local community and trained at MMHRC in public health aspects) makes group presentations on health and sanitation issues through a flip chart.

Telecare subcentres At present, two health centres at Anaiyur and Varapur are functioning on pilot basis. Every day nearly 15 to 20 patients receive health care services in respective centres. We provide patients with speciality consultations on Dermatology, Gynaecology, Cardiology, Diabetology, Paediatrics etc. The trained Village Health Guides are available at the remote site (health centre) to assist the doctor during the consultations. On arrival of patients at the health centre, village health guides attend the patients and connect to the doctor through the telecommunication link.

78

The health guides record the vital parameters using latest technology such as electronic stethoscope, electronic BP apparatus, etc through REMIDI KIT. All these vital parameters are stored in the server at our hospital, and retrieved when required for consultation and research. The doctor listens to the heartbeat, respiration and later talks to the patient through video conference and also writes the prescription using an electronic pad from the speciality centre (MMHRC). This prescription contains the doctor's signature and registration number, and is legally valid for purchasing medicines. This prescription is printed out and provided to the patient. As per doctors advice, the village health guide dispenses the medicines available. The village health guide / nurse who are well trained to handle minor emergency conditions that can be monitored from distance through telemedicine. Once stabilized and if required the patients are referred to a nearby tertiary care hospital or to MMHRC. In village, the health guide also visits every home and explains about the commonly prevalent diseases and creates awareness on such diseases.


ACADEMIC EXCELLENCE


World class care within everybody's reach

Library

Sharing knowledge is what we're best at‌ Our hospital library occupies a place of pride in the hospital and is an essential component of the hospital's outstanding research and education mission. It is a most lively place on the campus providing a safe, comfortable and friendly environment that enables learning, advancement of knowledge, promotes discovery and scholarship. The mission of our Library is to facilitate creation of new knowledge through acquisition, organization and dissemination of knowledge resources and providing for value added services. The library is open from 9.00 am to 9.00 pm on working days and 10.00 am to 1.00 pm on Sundays & Holidays. Our library has access to the digital Library as to ensure with all relevant information, resources that contains books, journals, website and research papers to suit the local conditions. S.No. Details

Numbers

I

Books

1. 2. 3. 4. 5.

Medical Books Managements Books Hospital Administration Miscellaneous Books Siddha Books

3069 3411 138 425 149

Total

6729

80

S.No. Details II 1. 2. 3. III 1. 2. IV

Numbers

Journals International 55 Topics Indian 58 Topics News Letter & Others 95 Topics Audio Cassettes Medical 61 Management 84 CD's (Medical & Management)1036


World class care within everybody's reach

Meenakshi Mission Hospital College A Division Of Meenakshi Mission Hospital And Research Centre

Our hospital is an emerging internationally renowned centre for education, to offer unique job oriented fulltime courses affiliated to Madurai Kamaraj University, Madurai, Mother Teresa Women's University, Kodaikanal and also a recognized centre for research and training in medical, nursing, paramedical and management since its inception. Most of the fulltime courses offered are first of its kind in Asia, developed with the aim of Imparting skill-based training to healthcare professionals of tomorrow's need.

81


Education Objectives Vision Developing Healthcare Professionals of Today's Relevance with Insight to Tomorrow's Need.

Mission Internationally Renowned Centre for Healthcare Education.

Courses Offered

Doctoral Studies Recognized by Madurai Kamaraj University and MGR Medical University for Ph.D. Programmes.

Royal College of Surgeons, Edinburgh The Royal College of Surgeons of Edinburgh, England has bestowed the recognition to train doctors seeking AFRCS Examinations.

National Board of Examinations Recognized by the National Board of Examinations to conduct Diploma in National

82

Board (D.N.B.) postgraduate courses in, 1. General Medicine. 2. Family Medicine. 3. General Surgery. 4. Gynaecology. 5. Anaesthesia. 6. Orthopaedics. 7. Radiology. 8. Genitourinary Surgery. 9. Surgical Gastroenterology. 10. Nephrology. 11. Cardiology. 12. Cardio Thoracic Surgery. 13. Neurology. 14. Neuro Surgery. 15. Minimal Access Surgery.


World class care within everybody's reach Medical Council of India (MCI) Recognized for Compulsory Rotatory Resident Internship and Senior House Surgeoncy for medical graduates.

Mother Teresa Women's University Following 3-years fulltime Bachelor Degree Courses are affiliated to Mother Teresa Women's University, Kodaikanal and admission is limited to females who have passed plustwo Science examinations. 1. B.B.A. – Hospital Administration. 2. B.Sc. – Applied Microbiology. 3. B.Sc. – Applied Biochemistry.

Indian Medical Association (IMA) Recognized to conduct the following 2-years fulltime Diploma Courses and admission is open to plustwo Science examinations. 1. Diploma in Medical Lab Technology (DMLT). 2. Diploma in X-ray Imaging Technology (DXIT). 3. Diploma in Operation Theatre Technician (DOTT).

Directorate of Distance Education – Madurai Kamaraj University Recognized as 'Training Centre' to offer the following one-year PG Diploma courses under Directorate of Distance Education, Madurai Kamaraj University: 1. PG Diploma in Hospital Management. 2. PG Diploma in Hospital Documentation Management. 3. PG Diploma in Health Information Management. 4. PG Diploma in Nutrition and Dietetics. 5. PG Diploma in Biostatistics. 6. PG Diploma in Hospital Laboratory Technology. 7. PG Diploma in Radiography and Imaging Technology. 8. PG Diploma in Pharmaceutical Chemistry.

Recognitions 1. Recognized as Post Graduate Institution by University of Colombo to train students in Post Graduate Diploma in Family Medicine.

Madurai Kamaraj University Approved institution to pursue a challenging and promising management career which is open to all graduates : 1. M.B.A. Hospital Administration. 2. PG Diploma in Fundraising Management. 3. PG Diploma in Micro Credit Management.

2. Recognized by Indian Medical Council to train students in the Diploma, Fellow of College of General Practitioners that will lead to Diploma in Family Medicine. 3. Recognized by several Universities in India and abroad for Research Projects. 4. Recognized Training Centre for Physiotherapists. 5. Recognized by all the leading Nursing Colleges for Internship.

4. PG Diploma in Medical Records Management.

6. Recognized for Management Internship.

5. PG Diploma in Total Quality Management in Hospitals.

7. Recognized by University IOWA for the Internship of their students.

83


World class care within everybody's reach Course wise Rank Holders are… UG Courses (Year 2006 – 2009) B.Sc. Applied Biochemistry - T. Mariaselvi B.Sc. Applied Microbiology - B. Jansirani B.B.A. Hospital Administration - S. Prasanna PG Course (Year 2007 - 2009) - also university topper : MBA Hospital Administration -Dr. Arpita Malani

PG Diploma Courses (Year 2008-2009) – also University Toppers

Re c o g n i z i n g Pa r e n t s Stakeholders in Education

as

Main

In the Students' Day 2006, we introduced “Recognising High Fliers”, of which the highlight is 'Parent of the Year' Award. In this academic year Mrs. V. Muthulakshmi and Mr. P. Veerasamy parents of P.V. Lakshmi, 3rd year student of B.Sc. Applied Biochemistry course were honoured with the Parent of the Year Award.

Endowment Fund Based on the Endowment Fund contributed by Dr. N. Sethuraman, Founder, MMHRC, Silver Medals were awarded to the University Toppers in UG courses initiated by MMHRC at Mother Teresa Women's University, Kodaikanal.

Admission and Student’s Strength In this academic year, we admitted 34 students in the UG courses, 76 students in the fulltime PG courses and 68 students in the distant education courses. The total strength in UG courses is 89 students, besides 93 students undergoing fulltime PG courses.

Academic Performance Students achieved 96.7% result in the University Examinations – April 2009 and 100% result in the University Examinations – Nov 2009. In the academic year ending 2009 totally 91 students were graduated. Fifty percent of our undergraduates have opted for higher studies and almost all other graduates were placed in suitable jobs through campus placement.

84

PG Diploma in Total Quality Management - N. Ramya PG Diploma in Microcredit Management - V. Annapoorani PG Diploma in Fundraising Management - C. Indrani

Diploma Courses (Year 2007 – 2009) Diploma in Medical Lab Technology

-S. Ilakkiya

Staff Composition Besides involving 24 in-house part time and visiting faculties we have increased the fulltime teaching faculty members to 10 thereby ensuring adequate fulltime teachers in the areas of Microbiology, Biochemistry, and Hospital Administration.

Parents Teachers Meet We facilitated “Parents – Teachers” Meet on biannual basis in April and Oct of this year with 99% attendance from Parents side, ensuring healthy discussions on the progress of Student’s performance and career growth.

National Youth Day We celebrated National Youth Day on Jan 12th 2010 in honour of Swami Vivekananda with the main focus to inspire youth. Quiz competition, debate and cultural programmes were organized to exhibit the skills of the students.

National Girl Child Day National Girl Child Day was celebrated on Jan 25, 2010 to create awareness of issue related to girls. The highlight of the celebration was the poster elocution competition on the three "Girl Child".


World class care within everybody's reach National Science Day We celebrated National Science Day on March 1, 2010 in commemorating Legacy of Sir CV Raman, with the basic objective to spread the message of importance of science and its application among the people. Scientific Model Making and Poster Presentation competitions were organized on that auspicious day based on the theme of the year “Exploring Energy”.

Women's Day Women's Day was celebrated on March 8, 2010 to highlight the 'Role and Importance of Women in the Society' among the Students community. Competitions on Poster Presentation and Fancy Dress were organized on the theme 'Equal rights, equal opportunities, progress for all'.

Student’s Day Competitions Towards Student’s Day, we organized competitions to exhibit the talents and skills of the students.

Programmes, Publications

Researches,

and

Prof. A.K. Sivakumar, the Principal, continued his service as Permanent Invitee Member, Executive Board, Ramlal Golchha Eye Hospital Foundation, Biratnagar, Nepal; Member, Academic Council, Madurai Kamaraj University; Senator, Madurai Kamaraj University; and as President, Federation of Hospital Administrators (Madurai Chapter). He served as Member, Expert Committee / Board of Studies, as well Visiting Faculty cum Chairman of Examinations for Management Studies and Health Science Programmes at Madurai Kamaraj University, Mother Teresa Women's University, and Bharathidasan University. He served as Member of the Advisory Committee Meeting of the NSS programmes of Mother Teresa Women's University, Kodaikanal and Rukmini Shanmugam Polytechnic College, Varichiyur.

Prof. G. Sharmil, HOD, was invited for a guest lecture on cancer Biology at the Department of Biochemistry and Microbiology, Nadar Saraswathi College of Arts and Science, Theni. Prof. G. Sharmil, HOD, continued her researches in biochemical spectrum in collabration with Centre for Medical Entomology, Indian Council of "Medical Research, Ministry of Health, Government of India. Mr. S. Ramkumar, Lecturer participated in the Workshop on Faculty Development on Entrepreneurship organized by the Centre for Entrepreneurship Development (TN), Madurai.

Practical Training / Additional Courses / Seminars Students of Management Courses underwent management training in 20 areas of the Hospital in partial fulfillment of the requirement of the course. Students visited different types of health care organizations like private / government hospitals, single / multi-specialty hospitals, nursing homes, clinics, health centres, health projects, diagnostic centres, etc. to get an understanding about the different types of providers in health care. Field visits / training programmes were organized exclusively for Science Course Students thereby they underwent observation training at Centre for Research in Medical Entomology, Agricultural College & Research Institute, Coonnoor Pasteur Institute, Food P r o c e s s i n g I n d u s t r y, D a i r y P r o d u c t s Manufacturing Units, etc. Students were actively involved in all our community outreach programmes and health care projects. Students had ample opportunities to develop their skills in events management, as they were totally involved in all our Continuing Medical Education / National as well International Seminars and other training programmes.

He was invited as the chief guest for the one day Seminar on New Horizons of HR and Marketing at Ayya Nadar Janaki Ammal (Autonomous) College, Sivakasi.

Students were encouraged to undergo the short courses offered at the campus in the areas of Medical Transcription, Spoken English, Spoken Hindi, Mushroom Cultivation, Vermi Composting, Food preservation & Home made products etc.

He was invited as a lead faculty on Quality and Marketing subjects in the Workshop on Faculty Development on Entrepreneurship organised by Centre for Entrepreneurship Development (TN), Madurai.

Besides, students were encouraged to actively participate in the community outreach Seminars, Workshops and Rallies etc. organized by MMHRC, as well other Educational Institutions and Healthcare Organizations. 85


World class care within everybody's reach

Leader in Health Information

86

0102 - 9002 tropeR launnA


DEVELOPMENTAL EXCELLENCE


World class care within everybody's reach

Promotional Initiatives The Marketing Wing

Goals for 2010 - 2011 I. Pursue and develop Medical Tourism. II. Conduct regular events & activities to enhance Hospital image. III. Go the extra mile to ensure consistency in providing 'CUSTOMER DELIGHT'. Publications of Research papers in MMJ, National & International Journals New Sign-Ups Star Health Insurance introduced by the Government for Low Income Groups. New Employee Service Insurance Company (ESIC) scheme signed with a revised rate structure.

88


World class care within everybody's reach

OUR PERFORMANCE Corporate Total No. of Patients : 3960 Total Revenue

: 4.5 Cr.

Growth (in %)

: 10 %

New Clients under process Nuclear Power Corporation of India, Kudankulam. Airports Authority of India. IPBL, Power, Tuticorin and Ramnad. National Thermal Power Corporation, Tuticorin.

Master Health Check Up No. of Clients

: 4707

Total Revenue

: 89.56 Lakhs

Growth (in %)

: 33 %

New initiatives under Master Health Check Up Infosys, Mysore. Vedanta, Tuticorin. Ministry of Home Affairs (Pre Employment Health Check Up), Govt. of India. CHEP India, Mumbai. So far,we have tied up with more than 70 institutions locally and nationally.

Insurance Total no. of patients : 3832 Total Revenue

: 13.5 Cr.

Growth (in %)

: 108 %

89


World class care within everybody's reach Well - Wishers Meet - 12th December 2009

CME Program CME Camps conducted in various districts by the “Meet-the-Doctors” Team and Doctors conferred with meritorious awards.

Camps & Events World Diabetes day – 14th November 2009

90


World class care within everybody's reach

Quality and Innovation “Quality is never an accident; it is always the result of high intention, sincere efforts, intelligent direction and skillful execution; it represents the wise choice of many alternatives.� William A Foster As the quote says, Quality & Innovation department believes that quality is never an accident & it is a result of collective efforts and commitment. We focus on quality improvement and implementing innovative ideas in each of our services. To achieve the same, we have implemented many programmes like patient feedbacks, rounds in patient care areas, suggestions from staff etc.

Our programmes ... Towards improving patient satisfaction We give utmost importance to each and every suggestion from patients as we realize that their satisfaction is the base for our hospital. Quality and Innovation analyzes customer feedback data in order to understand thoroughly how the care is being delivered. We collect feedback forms from the In-patients, Out patients and from the Master Health check up customers, to ensure quality in all levels. We also analyze and interpret customer satisfaction and amicably solves customer complaints. Immediate actions are taken to rectify the complaints and also an abstract is being sent to all the concerned departments for taking preventive and corrective actions. S.No.

Average/ Month (in %)

Description

1.

Appreciation

6

2.

Suggestion

6

3.

Complaints

2

Description

S.No. 1.

Customer Satisfaction Index

Average (in %) 87%

Complaints / Suggestions S.No.

Category / Department

Numbers

1.

Canteen

56

2.

Pharmacy

60

3.

Nursing

23

4.

HK

19

5.

Doctors

16

6.

Quality Service

13

7.

Billing

3

8.

Scan

1

9.

Lab

3

10.

Reception

3

11.

Security

12

12.

Others

2 91


World class care within everybody's reach Category wise Complaints & Suggestions Category

Complaints

Suggestions

12 61 83 29 11 7 63

12 104 26 362 38 5 114

Behaviour Cost Delay Facilities Information Others Service

Thank You Wall

The appreciation given by the patients are posted in a Wall named "Thank You Wall" which motivates our Meenakshi mission. FROM THE FAMILY !!! Spark Suggestion Scheme We give importance not only to the suggestion from our patients but also from our staff. We consider our staff who have been with us for a long time as the most precious asset. So we conduct a spark suggestion scheme to motivate & encourage the internal customers to give suggestions for hospital improvement. 'SPARK' scheme is made successful by conducting regular meetings and timely feedback to the staff. Employees and the departments who have contributed the maximum number of suggestions are honoured on Kaizen day as “Spark Masters”.

Quality Circles We act as a facilitator in bringing quality through “Quality Circles”. We have 12 quality circles from various departments of the hospital to make an in-depth and systematic study of the problems identified by the staff. 9 Quality Circle teams (ROSE - Nursing, GEM – A/C Plant, MINNOLI – Electrical, RED ROSE – Nursing, PHARMACON – Pharmacy, KUBERA – Billing, PINNACLE – Biomedical, SIGMA – Laboratory & BRIGHT – Laundry) participated in the 19th Chapter Convention at Ooty in September 2009 and received awards. Almost 120 Quality Circles teams have participated in the competition out of that our BRIGHT – Laundry QC has got “Overall Best Team Award”. S.No. 1

Convention 19th chapter convention, Ooty

Awards Par-Excellence Award for "Bright Pinnacle, Minnoli & Rose QC" Excellence Award for " GEM & Pharmacon QCs" Distinguished Award for "Kubera, Red Rose & Sigma QCs"

Studies conducted for the year As analytical studies and its results facilitate in decision making, Quality service Department engages itself in taking up timely relevant studies in various areas and to list a few. Mess Satisfaction Survey District wise analysis 92


World class care within everybody's reach

Resource and Development (R & D)

Some people have a way of being helpful‌ It seems they always know just where to be To lend a hand whenever one is needed, and help make things turn out successfully. Imagine a time when every person in Madurai has the chance of getting free services in keeping with our mission of achieving World - class health care within everybody's reach. R& D has helped realize this dream through fundraising, which is inspirational, creative, fun and brings in money and other resources. The department is responsible for all aspects of charity fundraising including partnerships with businesses and Charitable Trusts, work with schools and community groups, organizing special events and supporting individual fundraisers.

93


World class care within everybody's reach Strategic aims & objectives To raise funds and other resources for sustainability and expanding our services to the poor people. To raise the profile of S. R. Trust as a secular charitable institution providing world class care. To build a team of professional fundraisers. To mobilize and sustain community ownership towards achieving our mission. To mobilize and sustain government support and funds for our charitable activities. To ensure state-of-the art facilities and equipments to cater to the needs of the poor and the needy community. Through these strategic aims and objectives, we are making a big difference by mobilizing funds to continue our charitable services. R&D has also helped enhance the hospital's national reputation for research, prevention, care and cure for illnesses. Aim 1: Raise funds and other resources for sustainability and expanding our services to the poor people. Proposal writing is a major aspect of fundraising which is responsible for raising money from Trusts and Foundations. Support and funds are being generated for the work that the hospital does with women, children and young people. Proposal writing is very competitive which projects our work effectively is an everyday challenge. Direct Relief International(DRI), USA regularly supports us through medical supplies and equipments to serve the needy persons. DRI extended its support towards successful implementation of telemedicine project. Magen David Adom (MDA), UK one of the donor organizations helps us in receiving medical supplies. Americares India, Mumbai a disaster relief and humanitarian organization supports us since 2 years. Hospice care program has been established at our hospital and provides individualized care for the terminally ill and their families, regardless of race, color, creed, national origin, religious 94

affiliation or the ability to pay. Lions Club International helps us in executing the project. Gnanambal Palliative care centre started with the aim of providing the best quality of life for individuals, many of whom will be approaching death, and to offer comfort and support to their families and careers as well. Corrective cleft lip/palate surgeries for the poor… Our hospital established an exclusive Smile Train Centre for cleft lip/palate centre by the grant assistance of Smile Train, USA Blindness Control Program for children in collaboration with the Vitamin Angels Alliance, USA to wipe out Vitamin A deficiency among children. Ekam Project: Recently to treat the rural poor children who are in need of acute medical need, we have initiated a project in collaboration with the Ekam Trust, Chennai. APAC project: In collaboration with AIDS Prevention and Control Project (APAC), Chennai our hospital conducted sensitization programs for district level heads. Tamil Nadu Foundation: In collaboration with Tamil Nadu Foundation, our hospital conducts free eye camps at various districts. Telecare services to the poor: Our hospital initiated Telecare services in collaboration with the Indian Space Research Organization (ISRO) and DRI, USA. Recently new telemedicine units have been inaugurated at Anaiyoor, Madurai District and Varapur, Sivagangai District for treating rural persons to access health care facility at their door steps. Habitat for Humanity: With the help of Habitat for Humanity India, 100 new houses are built under the name “Millard Linda Habitat” at Kathapatti. 1000 more houses will be launched with the mission of building new houses to the poor with hope & happiness. Aim 2: Raise the profile of S. R. Trust as a secular charitable institution providing world class care. Celebration of Mother's day: 10thMay of every year is celebrated as Mother's Day to shower love on the most precious person on this earth, the Mother. Every year, mother's day is celebrated to honour this relationship and pay respect to all mothers.


World class care within everybody's reach World heart day 2009- Our hospital observed World Heart Day on 27th September 2009 in collaboration with Eco Park Walkers Association and Madurai Schools & Colleges by organizing a rally from Eco Park to Gandhi Museum to provide awareness about heart diseases. More than 250 members voluntarily participated in the rally. Global hand washing day - Our hospital observed Global Hand washing Day on October 15th by improving and reinforcing hygienic practices. Global Hand washing Day will be the centerpiece of a week of activities that will mobilize millions of people in more than 20 countries across five continents to wash their hands with soap. The program is concerned with improving hand hygiene everywhere in the world where health care is delivered.

Aim 3 : Build a team of professional fundraisers. Sections inside R&D Our team includes the Projects and Communication, Corporate fundraising, Grants and Innovation, Trusts fundraising, Special events, Charity box fundraising, Corporate fundraising, Micro finance fundraising, Volunteer development, Community fundraising and Direct marketing. Academic Excellence Besides, as part of our commitment toward building a core group of fundraising

Iftar feast festival - Our hospital is committed towards secularism. To emphasize this, Iftar feast festival was celebrated with Muslims. This reiterated our hospital's commitment to secularism. More than 100 members participated and celebrated it. Karthigai festival - Every year karthigai deepam festival is celebrated in the Meenakshi Temple at our hospital. All the patients, staff and other visitors celebrate this festival by joining hands with us. The participants generously donated for feeding the poor patients. Christmas day celebration- Christmas day was celebrated in collaboration with Methodist Church, Mahatma Gandhi Nagar, Madurai. Carol services were arranged and Pastor Sam Sodalaimuthu & his team of 12 members visited our general wards and prayed for our patients. Stress management program for school children: Our hospital conducts program on "Stress Management and Techniques" for school going students. This unique awareness program helps the students to cope up stress in their daily life. So far, we have covered more than 15 schools. NGO networking - Our hospital has a network of 365 NGOs in Tamil Nadu by a name "Consortium of Service Organizations in Tamil Nadu (CONSORT). To spread the message of HIV/AIDS, a forum - The Tamil Nadu Network of NGOs working for HIV/AIDS (TNN) has been functioning. 95


World class care within everybody's reach professionals in India, a Post Graduate Diploma Course in Fundraising, first of its kind in Asia has been introduced. We are in the 6th successful year of our Post Graduate Diploma in fundraising course. This is a recognized course in affiliation to Madurai Kamaraj University. Several other courses such as Micro credit, Total Quality Management and Business Administration have also been launched. These courses are designed as Job oriented Post Graduate Diploma programs and are well supported by Research and Training capacity building centre. Fundraising Expertise In fundraising, till date our hospital has successfully conducted 5 international conferences. Consultancy plays a major role in our fundraising activities. We have a network of federation of NGOs by name CONSORT (Consortium of Service Organizations in Tamil Nadu) which organize and conduct health camps, render social awareness programs, t raining, liaisoning with govern m e n t departments, attending issues concerning the voluntary sector, campaigning on development issues, conduct building and networking. Renowned fundraising speakers and consultants like Mr. Mal Warwick, Mr. Eva Aldrich, Dr. Lilya Wagner, Ms. Luce Moreau, Mr. Richard Pordes, Mr. George Taylor, Ms. Usha Menon, Mr. Surat Sandu and Mr. Joseph Scaria gave their expertise on fundraising. Aim 4:

Mobilize and sustain community ownership towards achieving our mission.

A broad range of people have chosen to volunteer for Meenakshi Mission. These people are from a variety of backgrounds which requires good communication at many different levels. This area is vital to our voluntary funds and therefore a key fundraising role. This year, we received students from University of IOWA under Stay and Study Program. Dr. Azra B Rezwi, Plastic Surgeon from Helping Hands International, Ms. Kristen Deluca, Speech Pathologist from Riley Hospital for Children and 96

Mr. Stephen, Mechanical Engineer under Medical Exchange Program of Smile Train USA. We also had Ms. Pooja Gandhi, Bio Medical Student from UK also served as a volunteer. An important part of our work goes on out in the community dealing with people from all walks of life. Our department adopts strategies towards successful fundraising initiatives‌. Impacts and Achievements S.No.

Techniques

Donations Received (in Rs.)

1

Face to Face

5,01,167

2

PRG (Pay Roll Giving)

6,18,032

3

Donation Box

4

Direct Mail

5

Online

6

School Fundraising

6

Health funds

7

Volunteer

8

Projects

9

Other Donation Donations Amount Total in kind donations worth

11,59,350 9,96,588 13,000 4,529 54,84,692 4,000 94,60,666 3,42,364 1,85,84,388 11,60,13,591

Charity box, which is placed for our charitable programs in all the districts of Tamil Nadu. More than 900 boxes are placed at various destinations. Regularly in a year, more than 11 lakhs are being generated. We also adopt Direct mail fundraising where a highly personalized package which communicates courtesy, consideration with excellent graphic design. Through direct mail, we get financial support and long term relationship with our donors. We are acquiring many donors for our programs such as, The Camila Children Cancer Fund program, which offers exclusive cancer treatment, costly drugs and diagnostic tests for children regardless of their paying capacity.


World class care within everybody's reach The “Save the Little Hearts� Program which provides quality heart surgeries to poor children suffering from Congenital Heart Disease (CHD). Pass on the goat program which is an initiative of Mahasemam Trust, a sister concern of S.R. Trust. The key concept is that each woman (a member) must pass on the offspring of female goat that was gifted to her to the other woman in a poor background. It creates an income and benefits the particular woman. More than 1000 families have been benefited from this program. Free food program: For more than 20 years, our hospital provides free nutritious food three times a day for the poor patients and their relatives. Many donors, supporters, and funders supports this noble program. We also provide Free Dialysis treatment for kidney failure patients, Free Cataract Surgeries for poor old patients, Hospice and Palliative care. Corporate Fundraising is increasingly competitive and the work is challenging. It is also widely varied and hugely rewarding.

Impacts and achievements (Free Services) Cleft lip/ palate surgeries

746

Food for the poor

41,110

Heart surgeries (Children)

28

Cataract surgeries

493

Family planning operations

446

Treatment for In Patients

8,722

Treatment for Out Patients

78,877

Medical camps

431

Palliative care treatment

724

Treatment for cancer children

12

Dialysis to poor patients

341

HIV counselling and testing under ICTC

TB treatment

Tested

3318

Counselling

3624 1326

Workplace Giving: Our hospital establishes payroll-giving program within the hospital to make all the employees to make them aware of the charity programs. Promoting payroll giving involves good communication at all levels with both large and small organizations and will bring into contact with a wide range of people in a variety of situations. Events are undoubtedly fun but it requires not only a creative mind and untold energy but also firm foundations in project management and business planning. We are a dynamic department dealing with all aspects of event fundraising. We are involved in event research, evaluation, planning, budgeting and patient care. There is never a dull moment and our portfolio of events cover the entire year and across Madurai and surrounding districts. Our events are key fundraising programmes, where cost efficiency along side Health & safety are of utmost importance. Meenakshi's events reinforce our brand and are key for promoting public awareness of our work and issues facing today. They create media opportunities and therefore provide sponsorship opportunities for our corporate supporters.

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One of our notable events is our “Great Duck Race” which is first time in India, “Fun Feast “ with the Music Director James Vasanthan as well as launch of an annual event called “Coffee with Celebrity-2010”. This year's celebrity being the numero uno film artiste of South-Sneha, will help generate much mileage and public support for our charitable activities. Online fundraising has also been a contributing factor for S. R. Trust's success. It is used for analyzing the websites of various funding agencies and NGO's globally. We maintain the website www.meenakshimission.org for its authentic news and ability to educate patients and society about social medical activities. Donor relations have been a vital for our organization success. S. R. Trust regularly conducts Donor Meet in honoring all the donors for their noble services. One step ahead, we publish our Quarterly Newsletter, Charity Journey, which is a gallery of all our charity activities. This year, Donor Meet was celebrated on July 26th 2009. 3 “Best Philanthropists Award” was given to Mr. T. Boopathy Rao - Kancheepuram, Mr. M.A. Rajeev-Madurai and Mr. N. Ramasamy, Mercury Cards, Madurai. Activities on charity work were presented by Dr. N. Sethuraman and Charity report was also released. Beneficiaries for various programs like Free Meals, Save t h e l i t t l e h e a r t s , Fa m i l y Counselling Centre, Cleft L i p / Pa l a t e s h a r e d t h e i r experience in the hospital. 98


World class care within everybody's reach

Database acts as a vital source to mobilize resources and to keep informed the society, NGOs, funders about our charitable activities. So far we could develop a potential database with more than 18,000 addresses. It includes the addresses of funding agencies, NGOs networks, Corporates, potential persons, individual donors, schools, colleges, hospitals etc. Aim 5: Mobilize and sustain government support and funds for our charitable activities. We work closely with many government departments to serve the poor persons with access to medical intervention. Creche and Play School Program initiated by The District Social Welfare Board, which caters to the needs of children from diverse social and cultural backgrounds, aged from 4 months to 3 years. The Creche aims to provide an environment for children which is safe, happy, loving and stimulating… More than 40 children are enrolled. Working Women Hostels aims to provide young women not only with reasonably priced housing but also opportunities for growth, making them self confident at the same time sensitive and responsible to other women. Community Care Centre As a Pioneer health care institution, our hospital instigated Community Care Centre by name “Mother Teresa Special Ward for PLWHAs” in the year 1997. The centre is provided with 10 beds with qualified medical officer and supportive staff to enhance comprehensive care and support services for the PLWHAs. In addition to the regular treatment to prolong the life of the PLWHAs, other supportive services like

counselling, health education, library, referral services for ART centre, free CD4 count test etc are provided. The health workers make field visit and meet the PLWHAs at their homes and integrate with the community. More than 20,000 PLWHAs benefited so far.

New project tie ups

Donors too shared also their experience in the hospital.

With increasing demand of companies and funding organizations to be more socially responsible here is huge potential to raise voluntary funds. We have successfully identified and developed mutually beneficial partnerships with a wide range of voluntary organizations across all sectors. On behalf of our Meenakshi Mission family, we thank the following donor organizations… Globus Relief, USA Intervol, USA Project Cure, USA International Aid, USA Lions Club International, USA Manov Jothi, Pune Cancer Aid and Research Foundation, Mumbai Integrated Counselling and Testing Centre (ICTC): With the support of Tamil Nadu State AIDS Control Society (TANSACS), our hospital provides Prevention of Parent to Child Transmission of HIV/AIDS (PPTCT) services are remodelled as a hub - 'Integrated Counselling and Testing Centre' (ICTC) to provide services to all clients under one roof. An ICTC is a place where a person is counselled and tested for HIV of his own free will or as advised by a medical provider. The main functions of an ICTC are: Conducting HIV diagnostic tests. Providing basic information on the modes of HIV transmission, and promoting behavioural change to reduce vulnerability. Link people with other HIV prevention, care and treatment services.

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World class care within everybody's reach Revised National Tuberculosis Control Program Our hospital under the aegis of WHO and District TB centre, Madurai is one of the microscopic centres and DOTS providers. We conduct free sputum test, free drugs and free counselling. This year we have treated 1187 patients. RNTCP III phase : Our hospital has been enrolled as an NGO/Private Provider in our district for the performance of designated microscope centre scheme in accordance with the Revised National Tuberculosis Control Program policy. MOU has been signed recently with the Deputy Director of Medical Services (TB unit), Madurai District. Family Counselling Centre Marital problems have become the most distressing in the lives of many married couples. Our family Counselling Centre counsel many such couples and help them to live in harmony. This year, we have served more than 400 families. Apart from Family Counselling, we also counsel cancer patients, HIV patients and others to live in peace at our hospital which is supported by Tamil Nadu Social Welfare Board, Chennai.

Aim 6: Ensure state of the equipments to cater to the needs of the poor and the needy Community Volunteer Management Conference 2009 As the concept of volunteerism is gaining importance among NGOs, the main aim of the conference is to develop new skills in volunteer resource management as to bring novel ideas on volunteerism. Our hospital organized a 2 days conference on "Volunteer Management" in collaboration with the ivolunteer, a not-for-profit organization working in the social sector in India, headquartered in Delhi. More than 200 delegates attended this conference this year.

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World class care within everybody's reach

Honour Roll List of Donors PROJECT DONORS 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16.

The Smile Train, USA The Direct Relief International (DRI), USA Magen David Adom (MDA), UK Vitamin Angels Alliance, USA Tides Foundation, USA University of IOWA, USA Indian Space Research Organization (ISRO), Bangalore Americares India, Mumbai Habitat for Humanity India (HFHI), Mumbai Ekam, Chennai Tamil Nadu State AIDS Control Society (TANSACS), Chennai The Central Social Welfare Board, New Delhi Tamil Nadu Foundation, Chennai Tamil Nadu State Social Welfare Board, Chennai AIDS Prevention and Control Project (APAC), Chennai District TB Centre, Madurai

INDIAN DONORS Free Meals

Sivagangai

Hyderabad

1. Mr. Chockalingam Arumugam

1. Mr. K. A. Raju

Theni

Bangaluru

1. Er. S. Baskaran

1.Mr. Ashok Kini

Tirunelveli

Chennai

1. Dr. M. Vaikundaraman 2. Mr. P. Kandasamy

1.Dr. P. Thirumalai 2.Mr. K.P. Haran And Family 3.Mr. C. Vijaya Kumar

Coimbatore 1. Mr. S. Ebenezer Sathyaseelan 2. Mr. Siva Balakrishnan

Trichy 1.Dr. R. Nirmala Manickam 2. Mr. R. Satagopan 3. Mr. S. Muthusamy 4. Mr. John Gunalan

Tuticorin

Dindigul

1. Mrs. N. Subbulakshmi

1. Mrs. V. Krishnammal 2. Mr. C.K.A. Abdul Kadir 3. Mr. A. Rajendran

Virudhunagar 1. Ms. S. Komathi

Tanjore

Camila Children Cancer Fund

1. Mrs. Kumari Anbunathan

USA

Madurai

1. Mr. Shan Thever

1. S.M. P.M. Foundation 2. K.V.K.R. Charitable Trust 3. Dr. K. Vijaya Kumar 4. Dr. N. Sethuraman

Rajapalayam 1. Mr. K. Velayutham

Hyderabad 1. Mr. Vinod kapoor

Coimbatore 1. Suchel Enterprises 2. Mr. K. Kannan 101


World class care within everybody's reach

Erode

Save the little Hearts

1. Mr. Dipu K. Thambi

Chennai

Kilakarai

1. Mr. T.S. Bala Subramanian Memorial Trust

1. M/s. Usvathun Hasana

2. Omayal Achi Mr. Arunachalam Trust

Charitable Trust

3. Mrs. Uma Janardhanan

Madurai

Madurai

1.Dr. Somasundaram Jayabose, MMHRC 2.Mr. P. Kannan 3. Mr. M. A. Rajeev 4. Mr. S. P. Gopala Krishnan

1. Mr. V.R. Siva Senthil

Eye Care Kanchipuram

Tuticorin

1. Mr. D. Boopathy Rao

1. JTK Charitable Trust 2. Mrs. N. Subbulakshmi

2. Mr. V.R.R. Ramalingam

Salem 1. Mr. A. M. Murugan

We thank all the staff of our hospital and Mahasemam Trust, Madurai. We thank all the individuals and organizations who support us. Our special thanks to our Major Donors, Government Departments, Corporates, Sponsorers, Volunteers, Well Wishers and Trustees all through our services.

Your entire donation makes a difference!

102


FINANCIALS


World class care within everybody's reach

Income and Expenditure Statement

104


World class care within everybody's reach

Balance Sheet

105


World class care within everybody's reach

Performance Highlights Total number of Cardio Thoracic Procedures

544

Coronary Angiograms performed

2334

Total MLC in Accident & Emergency

2492

Heamodialysis

12652

Customer Satisfaction Index

87%

Patients Flow

Annual Turnover Growth

106 Thee Classic Printers Madurai Phone 2323819




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